Provider Demographics
NPI:1013291905
Name:YOSHIDA, SCOTT RANDY (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:RANDY
Last Name:YOSHIDA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2707
Mailing Address - Country:US
Mailing Address - Phone:818-790-5492
Mailing Address - Fax:
Practice Address - Street 1:12737 GLENOAKS BLVD STE 27
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4777
Practice Address - Country:US
Practice Address - Phone:818-362-6894
Practice Address - Fax:818-362-6896
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 37925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist