Provider Demographics
NPI:1396034906
Name:NIINO, GARY YUKIO (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:YUKIO
Last Name:NIINO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2200 E EL MONTE WAY
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-9377
Mailing Address - Country:US
Mailing Address - Phone:559-591-1401
Mailing Address - Fax:559-591-0977
Practice Address - Street 1:2200 E EL MONTE WAY
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-9377
Practice Address - Country:US
Practice Address - Phone:559-591-1401
Practice Address - Fax:559-591-0977
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist