Healthcare Provider Details

I. General information

NPI: 1982924510
Provider Name (Legal Business Name): LASIE YONG PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 E AMAR RD
WEST COVINA CA
91792-1618
US

IV. Provider business mailing address

1528 E AMAR RD
WEST COVINA CA
91792-1618
US

V. Phone/Fax

Practice location:
  • Phone: 626-965-2016
  • Fax: 626-965-5386
Mailing address:
  • Phone: 626-965-2016
  • Fax: 626-965-5386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 42399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: