Provider Demographics
NPI:1003951146
Name:POON, RAYMOND TAILING (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:TAILING
Last Name:POON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 GLORIA RD
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2123
Mailing Address - Country:US
Mailing Address - Phone:626-529-3311
Mailing Address - Fax:626-325-3143
Practice Address - Street 1:2331 E CESAR E CHAVEZ AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1810
Practice Address - Country:US
Practice Address - Phone:323-260-7333
Practice Address - Fax:323-261-6782
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH27304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH27304OtherREGISTERED PHARMACIST