Healthcare Provider Details

I. General information

NPI: 1225963614
Provider Name (Legal Business Name): WAHLE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27111 ALISO CREEK RD STE 150
ALISO VIEJO CA
92656-3367
US

IV. Provider business mailing address

27111 ALISO CREEK RD STE 150
ALISO VIEJO CA
92656-3367
US

V. Phone/Fax

Practice location:
  • Phone: 949-605-5667
  • Fax:
Mailing address:
  • Phone: 949-605-5667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. AUSTIN LEE WAHLE
Title or Position: PIC
Credential: PHARMD
Phone: 949-605-5667