MEDICARE: KAITLYN MIKA LEHTOLA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	87181	CA

General Provider Information

NPI Number	:	1083310965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN MIKA LEHTOLA PHARMD

Provider Business Mailing Address
First Line	:	3515 HARBOR BLVD
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-1437
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5822 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3712
Country	:	US
Telephone Number	:	323-750-5222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	06/04/2026

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