Provider Demographics
NPI:1578092144
Name:KHO, YINTAT WILLIAM (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:YINTAT
Middle Name:WILLIAM
Last Name:KHO
Suffix:
Gender:M
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 1:650 N BROADWAY STE B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2802
Mailing Address - Country:US
Mailing Address - Phone:213-617-3322
Mailing Address - Fax:213-617-2288
Practice Address - Street 1:650 N BROADWAY STE B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2802
Practice Address - Country:US
Practice Address - Phone:213-617-3322
Practice Address - Fax:213-617-2288
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49713183500000X
CARPH497131835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist