MEDICARE: DR. ANH LE PHARM.D.

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	63828	CA

General Provider Information

NPI Number	:	1649552340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANH LE PHARM.D.

Provider Business Mailing Address
First Line	:	9200 ELK GROVE FLORIN RD
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1609
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 ELK GROVE FLORIN RD
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1609
Country	:	US
Telephone Number	:	916-687-3251
Fax Number	:

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

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	09/21/2011

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