Provider Demographics
NPI:1063457687
Name:YABUTA, RICHARD T (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:T
Last Name:YABUTA
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 1:3139 W 179TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-4009
Mailing Address - Country:US
Mailing Address - Phone:310-324-2718
Mailing Address - Fax:
Practice Address - Street 1:3139 W 179TH ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-4009
Practice Address - Country:US
Practice Address - Phone:310-324-2718
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist