MEDICARE: YUAN JEANIE SON

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	19364	MD
2	183500000X	Pharmacist	73230	CA

General Provider Information

NPI Number	:	1487935409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUAN JEANIE SON

Provider Business Mailing Address
First Line	:	7625 EASTERN AVE STE C
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-4515
Country	:	US
Telephone Number	:	323-773-3800
Fax Number	:	562-928-6275

Provider Business Practice Location Address
First Line	:	7625 EASTERN AVE STE C
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-4515
Country	:	US
Telephone Number	:	323-773-3800
Fax Number	:	562-928-6275

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

Provider Enumeration Date	:	09/03/2011
Last Update Date	:	01/04/2021

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Directions to “ YUAN JEANIE SON ” Practice Location

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