Provider Demographics
NPI:1467748707
Name:YOSHIDA, GEORGE GOGI (RPH)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GOGI
Last Name:YOSHIDA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12100 HARBOR BLVD
Mailing Address - Street 2:T-0192
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-4004
Mailing Address - Country:US
Mailing Address - Phone:714-971-0197
Mailing Address - Fax:714-971-0197
Practice Address - Street 1:12100 HARBOR BLVD
Practice Address - Street 2:T-0192
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4004
Practice Address - Country:US
Practice Address - Phone:714-971-0197
Practice Address - Fax:714-971-0197
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH49975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist