Provider Demographics
NPI:1164113056
Name:SOMSY, TING (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MISS
First Name:TING
Middle Name:
Last Name:SOMSY
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:TING
Other - Middle Name:
Other - Last Name:KEOVILAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:6690 N IVANHOE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3051
Mailing Address - Country:US
Mailing Address - Phone:559-907-0678
Mailing Address - Fax:559-225-0114
Practice Address - Street 1:2011 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3404
Practice Address - Country:US
Practice Address - Phone:559-224-0920
Practice Address - Fax:559-225-0114
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH46100183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician