Provider Demographics
NPI:1255592879
Name:YOON, HYUN SANG (RPH)
Entity type:Individual
Prefix:MR
First Name:HYUN
Middle Name:SANG
Last Name:YOON
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 14TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3906
Mailing Address - Country:US
Mailing Address - Phone:510-832-4747
Mailing Address - Fax:510-832-6171
Practice Address - Street 1:337 14TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3906
Practice Address - Country:US
Practice Address - Phone:510-832-4747
Practice Address - Fax:510-832-6171
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA366480Medicaid