Individual
DR. KY SAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5329 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97211-3237
(503) 988-8264
Mailing address
2700 DOLBEER ST, PHARMACY, EUREKA, CA 95501-4736
(707) 445-8121
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
53066
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W598753
PHARMACIST
CA
Enumeration date
01/06/2007
Last updated
06/13/2023
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