MEDICARE: YOUNGHAE PHARMACY 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	56062	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
2	2159066	OTHER		PK

General Provider Information

NPI Number	:	1972515195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNGHAE PHARMACY INC

Provider Business Mailing Address
First Line	:	20141 PIONEER BLVD
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90715-1051
Country	:	US
Telephone Number	:	562-866-5795
Fax Number	:	562-866-0257

Provider Business Practice Location Address
First Line	:	20141 PIONEER BLVD
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90715-1051
Country	:	US
Telephone Number	:	562-866-5795
Fax Number	:	562-866-0257

Authorized Official
Title or Position	:	OWNER/PHARM
Name	:	HAE ROH
Credential	:
Telephone Number	:	562-866-6011

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	09/19/2025

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Directions to “YOUNGHAE PHARMACY INC ” Practice Location

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