Provider Demographics
NPI:1508841677
Name:YOSHIMURS, KENJI (RPH)
Entity Type:Individual
Prefix:MR
First Name:KENJI
Middle Name:
Last Name:YOSHIMURS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 C ST
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-1706
Mailing Address - Country:US
Mailing Address - Phone:209-745-1591
Mailing Address - Fax:209-745-7493
Practice Address - Street 1:811 C ST
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-1706
Practice Address - Country:US
Practice Address - Phone:209-745-1591
Practice Address - Fax:209-745-7493
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA36884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist