MEDICARE: DR. RAYNOLD VANN YIN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	69104	CA

General Provider Information

NPI Number	:	1235561119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYNOLD VANN YIN PHARMD

Provider Business Mailing Address
First Line	:	9550 FREMONT AVE
Second Line	:	APT/SUITE L-12
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-2327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3558 RUFFIN RD STE 101
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2596
Country	:	US
Telephone Number	:	858-627-5644
Fax Number	:	858-636-2236

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	01/04/2022

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