Healthcare Provider Details

I. General information

NPI: 1669792206
Provider Name (Legal Business Name): RONALD HIROSHI YAMASHITA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2010
Last Update Date: 06/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 W MAIN ST
VENTURA CA
93001-2509
US

IV. Provider business mailing address

2105 RHONDA ST
OXNARD CA
93036-2243
US

V. Phone/Fax

Practice location:
  • Phone: 805-643-1121
  • Fax: 805-643-8634
Mailing address:
  • Phone: 805-983-0702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: