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General NPI Number Information
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NPI Number | 1851776389
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Entity Type | Individual
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Provider Name | KELESSERY YAH FANNY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 80 7TH AVE APT 4
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1243
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Country | US
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Telephone | 415-254-1741
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Fax |
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Provider Business Mailing Address
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Address Line | 80 7TH AVE APT 4
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1243
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Country | US
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Telephone | 415-254-1741
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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 | PH100001086
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60483711
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 87757
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License Number State | CA
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