Provider Demographics
NPI:1558716340
Name:NYI, TZU FANG
Entity Type:Individual
Prefix:DR
First Name:TZU FANG
Middle Name:
Last Name:NYI
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 1:1701 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5803
Mailing Address - Country:US
Mailing Address - Phone:323-731-9247
Mailing Address - Fax:323-731-0893
Practice Address - Street 1:1701 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5803
Practice Address - Country:US
Practice Address - Phone:323-731-9247
Practice Address - Fax:323-731-0893
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist