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NPI Code Detail

MEDICARE: GOLD SUN YUAN INC

MEDICARE: GOLD SUN YUAN INC
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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPHY48299CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12113451OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245323674
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLD SUN YUAN INC
Provider Business Mailing Address
First Line : 201 W GARVEY AVE
Second Line : STE 107
City : MONTEREY PARK
State : CA
Zip : 91754-7418
Country : US
Telephone Number : 626-572-0800
Fax Number : 626-572-8505
Provider Business Practice Location Address
First Line : 201 W GARVEY AVE
Second Line : STE 107
City : MONTEREY PARK
State : CA
Zip : 91754-7418
Country : US
Telephone Number : 626-572-0800
Fax Number : 626-572-8505
Authorized Official
Title or Position : CFO
Name : TONY TSE
Credential : RPH
Telephone Number : 626-572-0800
Provider Enumeration Date : 09/30/2006
Last Update Date : 11/25/2015

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Directions to “GOLD SUN YUAN INC ” Practice Location

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