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General NPI Number Information
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NPI Number | 1295463347
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Entity Type | Individual
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Provider Name | YESHAREG EABISA PHARMACY TECHNICIAN
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Gender | Female
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 9864 NATIONAL BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90034-2713
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Country | US
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Telephone | 310-836-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 JASMINE AVE APT 1
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City | LOS ANGELES
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State | CA
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Zip | 90034-3853
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Country | US
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Telephone | 310-569-1273
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 12372054
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License Number State | CA
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