Provider Demographics
NPI:1871706325
Name:KWOCK, YUMON (RPH)
Entity type:Individual
Prefix:
First Name:YUMON
Middle Name:
Last Name:KWOCK
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 1:411 HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4416
Mailing Address - Country:US
Mailing Address - Phone:707-443-8039
Mailing Address - Fax:707-443-1281
Practice Address - Street 1:411 HARRIS ST
Practice Address - Street 2:411 HARRIS ST.
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4416
Practice Address - Country:US
Practice Address - Phone:707-443-8039
Practice Address - Fax:707-443-1281
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist