Provider Demographics
NPI:1205105772
Name:YUN, RATANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RATANA
Middle Name:
Last Name:YUN
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:PO BOX 6308
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-6308
Mailing Address - Country:US
Mailing Address - Phone:559-635-7959
Mailing Address - Fax:
Practice Address - Street 1:24863 W. JAYNE AVE
Practice Address - Street 2:PVSP PHARMACY DEPARTMENT
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210
Practice Address - Country:US
Practice Address - Phone:559-935-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist