Provider Demographics
NPI:1215697537
Name:MANSOUR, YOLIANA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:YOLIANA
Middle Name:
Last Name:MANSOUR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 EDIE CT
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-3209
Mailing Address - Country:US
Mailing Address - Phone:626-675-2732
Mailing Address - Fax:
Practice Address - Street 1:3299 E HILL ST STE 301
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-1231
Practice Address - Country:US
Practice Address - Phone:562-597-6800
Practice Address - Fax:562-597-6844
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist