# MYGENBIO, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700603321
- **Authorized official:** MR. STEVE YUM (CFO)
- **Authorized official phone:** (408) 472-4771

## Contact information

- **Practice address:** 160 E TASMAN DR \# 210, SAN JOSE, CA 95134-1619
- **Practice address phone:** (669) 307-3650
- **Mailing address:** 160 E TASMAN DR \# 210, SAN JOSE, CA 95134-1619
- **Mailing address phone:** (669) 307-3650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335G00000X | Medical Foods Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 09/24/2024
- **Last updated:** 09/24/2024