Provider Demographics
NPI:1548602485
Name:QUACH, YEN (PHARM D)
Entity Type:Individual
Prefix:
First Name:YEN
Middle Name:
Last Name:QUACH
Suffix:
Gender:F
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 1:2499 WHIPPLE RD
Mailing Address - Street 2:T-1472
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-7807
Mailing Address - Country:US
Mailing Address - Phone:510-471-9266
Mailing Address - Fax:
Practice Address - Street 1:2499 WHIPPLE RD
Practice Address - Street 2:T-1472
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-7807
Practice Address - Country:US
Practice Address - Phone:510-471-9266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist