Provider Demographics
NPI:1720740582
Name:YANG, TEEJ-SHAO PHEEM (RPH)
Entity Type:Individual
Prefix:DR
First Name:TEEJ-SHAO PHEEM
Middle Name:
Last Name:YANG
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 1:1065 W MANNING AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2446
Mailing Address - Country:US
Mailing Address - Phone:559-638-0467
Mailing Address - Fax:559-638-0457
Practice Address - Street 1:1065 W MANNING AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2446
Practice Address - Country:US
Practice Address - Phone:559-638-0467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist