Provider Demographics
NPI:1144941873
Name:VANG-YANG, MAI KER (PHARMD)
Entity type:Individual
Prefix:
First Name:MAI
Middle Name:KER
Last Name:VANG-YANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MAI
Other - Middle Name:KER
Other - Last Name:VANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8832 APRICOT WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8832 APRICOT WOODS WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1228
Practice Address - Country:US
Practice Address - Phone:916-803-8192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist