Provider Demographics
NPI:1801181771
Name:YOCHIM, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:YOCHIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9670 PROMINENT PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-5000
Mailing Address - Country:US
Mailing Address - Phone:719-302-4267
Mailing Address - Fax:
Practice Address - Street 1:9670 PROMINENT PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-5000
Practice Address - Country:US
Practice Address - Phone:719-302-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17569183500000X
MO2002022116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist