Provider Demographics
NPI:1669461158
Name:OAKLAND YOON'S PHARMACY
Entity Type:Organization
Organization Name:OAKLAND YOON'S PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:SANG
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-832-4747
Mailing Address - Street 1:337 14TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3906
Mailing Address - Country:US
Mailing Address - Phone:510-832-4747
Mailing Address - Fax:510-832-6171
Practice Address - Street 1:337 14TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3906
Practice Address - Country:US
Practice Address - Phone:510-832-4747
Practice Address - Fax:510-832-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY36648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA366480Medicaid