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General NPI Number Information
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NPI Number | 1154031250
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Entity Type | Individual
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Provider Name | JINGYING JIAO
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Gender | Female
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 934 N HACIENDA BLVD
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City | LA PUENTE
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State | CA
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Zip | 91744-2845
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Country | US
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Telephone | 626-934-1926
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 OTTERBEIN AVE SPC 113
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2246
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Country | US
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Telephone | 626-678-3878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH87345
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License Number State | CA
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