Provider Demographics
NPI:1750788519
Name:LIN, YAN FENG (RPH)
Entity type:Individual
Prefix:
First Name:YAN
Middle Name:FENG
Last Name:LIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6378 COMMERCE BLVD
Mailing Address - Street 2:CVS PHARMACY
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2404
Mailing Address - Country:US
Mailing Address - Phone:707-586-3494
Mailing Address - Fax:
Practice Address - Street 1:6378 COMMERCE BLVD
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2404
Practice Address - Country:US
Practice Address - Phone:707-586-3494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-3694183500000X
CARPH 71721183500000X
ORRPH-0014451183500000X
WAPH60520955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist