Provider Demographics
NPI:1497424154
Name:YIN, SANY
Entity Type:Individual
Prefix:
First Name:SANY
Middle Name:
Last Name:YIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14629 7TH ST
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-4019
Mailing Address - Country:US
Mailing Address - Phone:760-245-6600
Mailing Address - Fax:760-245-1149
Practice Address - Street 1:14629 7TH ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4019
Practice Address - Country:US
Practice Address - Phone:760-245-6600
Practice Address - Fax:760-245-1149
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician