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General NPI Number Information
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NPI Number | 1538254057
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Entity Type | Organization
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Legal Business Name | KYEUNG SUK YEH
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 966 S WESTERN AVE #103
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City | LOS ANGELES
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State | CA
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Zip | 90006-1014
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Country | US
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Telephone | 323-733-7788
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Fax | 323-733-4818
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Provider Business Mailing Address
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Address Line | 966 S WESTERN AVE #103
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City | LOS ANGELES
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State | CA
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Zip | 90006-1014
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Country | US
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Telephone | 323-733-7788
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Fax | 323-733-4818
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Authorized Official
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Title or Position | PIC,OWNER
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Name | KYEUNG SUK YEH
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Credential | RPH
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Telephone | 323-733-7788
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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 | PHY40269
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License Number State | CA
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