1538682067 NPI number — YIFENG LI PHARMD

Table of content: YIFENG LI PHARMD (NPI 1538682067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538682067 NPI number — YIFENG LI PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LI
Provider First Name:
YIFENG
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538682067
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
975 SERENO DRIVE
Provider Second Line Business Mailing Address:
HOSPITAL 2010 TOWER, 3RD FLOOR INPATIENT PHARMACY
Provider Business Mailing Address City Name:
VALLEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94589-2141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-651-2794
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
975 SERENO DR
Provider Second Line Business Practice Location Address:
ONCOLOGY PHARMACY MEDICAL OFFICE BUILDING 2ND FLOOR
Provider Business Practice Location Address City Name:
VALLEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94589-2441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-651-2794
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  75300 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)