Provider Demographics
NPI:1740870237
Name:HUANG YE, FABIO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FABIO
Middle Name:
Last Name:HUANG YE
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 1:6020 KINGSMILL TER
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7462
Mailing Address - Country:US
Mailing Address - Phone:510-493-8555
Mailing Address - Fax:
Practice Address - Street 1:1095 HWY 95
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NV
Practice Address - Zip Code:89415-7771
Practice Address - Country:US
Practice Address - Phone:775-945-2159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018233183500000X
NV20787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist