Provider Demographics
NPI:1770662702
Name:PYO, NANCY LEW (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LEW
Last Name:PYO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 MAGNOLIA AVE
Mailing Address - Street 2:PHARMACY ADMINISTRATION,RMC-5, RM5506
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3043
Mailing Address - Country:US
Mailing Address - Phone:951-353-4143
Mailing Address - Fax:951-353-5246
Practice Address - Street 1:10800 MAGNOLIA AVE
Practice Address - Street 2:PHARMACY ADMINISTRATION, RMC-5 RM 5506
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3043
Practice Address - Country:US
Practice Address - Phone:951-353-4143
Practice Address - Fax:951-353-5246
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist