Healthcare Provider Details

I. General information

NPI: 1881027886
Provider Name (Legal Business Name): BERNICE LEUNG PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4593 N CEDAR AVE
FRESNO CA
93726-2540
US

IV. Provider business mailing address

4593 N CEDAR AVE
FRESNO CA
93726-2540
US

V. Phone/Fax

Practice location:
  • Phone: 559-222-2472
  • Fax:
Mailing address:
  • Phone: 559-222-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number68873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: