Provider Demographics
NPI:1922374875
Name:YAMAMOTO, ANNA LY (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:LY
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7859 SOUTH 3200 WEST
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088
Mailing Address - Country:US
Mailing Address - Phone:801-255-7557
Mailing Address - Fax:801-255-4876
Practice Address - Street 1:4201 TORRANCE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4579
Practice Address - Country:US
Practice Address - Phone:310-543-1111
Practice Address - Fax:310-543-1114
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7624688-1701183500000X
CA55841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist