Provider Demographics
NPI:1497070304
Name:OH, JIYOUNG KATERINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JIYOUNG
Middle Name:KATERINA
Last Name:OH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 CAMINO DEL RIO N
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-5701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3131 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 700
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-5701
Practice Address - Country:US
Practice Address - Phone:619-610-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10791183500000X
CA66357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist