1336272806 NPI number — A G K INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336272806 NPI number — A G K INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A G K INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
YAN YAN PHARMACY
Provider Other Organization Name Type Code:
3
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:
1336272806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 N GARFIELD AVE STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTEREY PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91754-1709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-572-7261
Provider Business Mailing Address Fax Number:
626-288-1716

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
228 N GARFIELD AVE STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTEREY PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91754-1709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-572-7261
Provider Business Practice Location Address Fax Number:
626-288-1716
Provider Enumeration Date:
03/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YEUNG
Authorized Official First Name:
FRANCES
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
626-572-7261

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PHY46035 , 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)

  • Identifier: PHA460350 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0572328 . This is a "NABP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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