Provider Demographics
NPI:1073940094
Name:WARNOCK, ANDREW KYUNG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:KYUNG
Last Name:WARNOCK
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 1:4993 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0751
Mailing Address - Country:US
Mailing Address - Phone:213-309-6463
Mailing Address - Fax:
Practice Address - Street 1:4993 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-0751
Practice Address - Country:US
Practice Address - Phone:213-309-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist