MEDICARE: KYEUNG SUK YEH

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	PHY40269	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1538254057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYEUNG SUK YEH

Provider Business Mailing Address
First Line	:	966 S WESTERN AVE
Second Line	:	#103
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-1014
Country	:	US
Telephone Number	:	323-733-7788
Fax Number	:	323-733-4818

Provider Business Practice Location Address
First Line	:	966 S WESTERN AVE
Second Line	:	#103
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-1014
Country	:	US
Telephone Number	:	323-733-7788
Fax Number	:	323-733-4818

Authorized Official
Title or Position	:	PIC,OWNER
Name	:	KYEUNG SUK YEH
Credential	:	RPH
Telephone Number	:	323-733-7788

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/18/2017

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Directions to “KYEUNG SUK YEH ” Practice Location

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