Provider Demographics
NPI:1114712841
Name:NGA, YANNICK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YANNICK
Middle Name:
Last Name:NGA
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14807 PIONEER BLVD APT 60
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-5878
Mailing Address - Country:US
Mailing Address - Phone:310-995-9657
Mailing Address - Fax:
Practice Address - Street 1:18421 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4609
Practice Address - Country:US
Practice Address - Phone:310-995-9657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23737183500000X
TX73369183500000X
FLPS59797183500000X
AZS026911183500000X
OR0019837183500000X
CA89544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist