Provider Demographics
NPI:1033489323
Name:QIAO, YINGFENG (RPH)
Entity Type:Individual
Prefix:MS
First Name:YINGFENG
Middle Name:
Last Name:QIAO
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 1:2117 BEAUJOLAIS CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5870
Mailing Address - Country:US
Mailing Address - Phone:415-305-4759
Mailing Address - Fax:
Practice Address - Street 1:2117 BEAUJOLAIS CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5870
Practice Address - Country:US
Practice Address - Phone:415-305-4759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist