Provider Demographics
NPI:1457686354
Name:YANG, LUE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LUE
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 REYNOLDS RANCH PKWY
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-6848
Mailing Address - Country:US
Mailing Address - Phone:209-366-7301
Mailing Address - Fax:209-366-7302
Practice Address - Street 1:2680 REYNOLDS RANCH PKWY
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-6848
Practice Address - Country:US
Practice Address - Phone:209-366-7301
Practice Address - Fax:209-366-7302
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 61254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist