MEDICARE: MISS YEA-SHIN YEH PHARMACIST

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	64378	CA

General Provider Information

NPI Number	:	1780991539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS YEA-SHIN YEH PHARMACIST

Provider Business Mailing Address
First Line	:	3800 W DEVONSHIRE AVE
Second Line	:	APT A37
City	:	HEMET
State	:	CA
Zip	:	92545-2361
Country	:	US
Telephone Number	:	909-996-1366
Fax Number	:

Provider Business Practice Location Address
First Line	:	1605 S SAN JACINTO AVE
Second Line	:
City	:	SAN JACINTO
State	:	CA
Zip	:	92583-5181
Country	:	US
Telephone Number	:	951-654-4734
Fax Number	:

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

Provider Enumeration Date	:	08/31/2010
Last Update Date	:	08/31/2010

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