Provider Demographics
NPI:1588004519
Name:YEE-MANGINDIN, CAREN FAI SHUI (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAREN
Middle Name:FAI SHUI
Last Name:YEE-MANGINDIN
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 1:660 W MARCH LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6200
Mailing Address - Country:US
Mailing Address - Phone:209-478-0891
Mailing Address - Fax:209-478-1168
Practice Address - Street 1:660 W MARCH LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6200
Practice Address - Country:US
Practice Address - Phone:209-478-0891
Practice Address - Fax:209-478-1168
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist