Provider Demographics
NPI:1922162742
Name:FAT, RAYMOND YEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:YEE
Last Name:FAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5270 ELVAS AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-2332
Mailing Address - Country:US
Mailing Address - Phone:916-739-1513
Mailing Address - Fax:916-739-6674
Practice Address - Street 1:5270 ELVAS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-2332
Practice Address - Country:US
Practice Address - Phone:916-739-1513
Practice Address - Fax:916-739-6674
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH28719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA349100Medicaid
CA0591859OtherNABP