Provider Demographics
NPI:1962814269
Name:YU, HENRY (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:YU
Suffix:
Gender:M
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 1:3020 FLOYD AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9637
Mailing Address - Country:US
Mailing Address - Phone:209-551-6030
Mailing Address - Fax:
Practice Address - Street 1:3020 FLOYD AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9637
Practice Address - Country:US
Practice Address - Phone:209-551-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist