Provider Demographics
NPI:1306956321
Name:YANG, JOUNG SOOK (RPH)
Entity type:Individual
Prefix:
First Name:JOUNG SOOK
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 N AZUSA AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2936
Mailing Address - Country:US
Mailing Address - Phone:626-969-4202
Mailing Address - Fax:626-969-5142
Practice Address - Street 1:507 N AZUSA AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2936
Practice Address - Country:US
Practice Address - Phone:626-969-4202
Practice Address - Fax:626-969-5142
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH54551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist