Provider Demographics
NPI:1336701150
Name:LIAO, YU LING BENJAMIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:YU LING
Middle Name:BENJAMIN
Last Name:LIAO
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 1:1135 S SAN GABRIEL BLVD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3114
Mailing Address - Country:US
Mailing Address - Phone:626-871-0181
Mailing Address - Fax:626-872-0182
Practice Address - Street 1:1135 S SAN GABRIEL BLVD UNIT 2
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3114
Practice Address - Country:US
Practice Address - Phone:626-872-0181
Practice Address - Fax:626-872-0182
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist