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General NPI Number Information
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NPI Number | 1255941282
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Entity Type | Individual
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Provider Name | SONG YI HAN RPH
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 4224 E SHIELDS AVE
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City | FRESNO
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State | CA
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Zip | 93726-7120
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Country | US
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Telephone | 559-271-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 8680 N GLENN AVE APT 167
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City | FRESNO
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State | CA
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Zip | 93711-6941
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Country | US
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Telephone | 408-890-0388
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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 | 81362
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License Number State | CA
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