MEDICARE: MRS. BETTINA PANGILINAN YALUNG

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	183700000X	Pharmacy Technician	190102988712722	HI

General Provider Information

NPI Number	:	1750567509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETTINA PANGILINAN YALUNG

Provider Business Mailing Address
First Line	:	2664 SHOUP DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4268
Country	:	US
Telephone Number	:	619-222-0216
Fax Number	:

Provider Business Practice Location Address
First Line	:	2664 SHOUP DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4268
Country	:	US
Telephone Number	:	619-222-0216
Fax Number	:

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

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	01/10/2008

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