Healthcare Provider Details

I. General information

NPI: 1831454875
Provider Name (Legal Business Name): CHANH TRI LE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N EL CIELO RD
PALM SPRINGS CA
92262-6972
US

IV. Provider business mailing address

275 N EL CIELO RD
PALM SPRINGS CA
92262-6972
US

V. Phone/Fax

Practice location:
  • Phone: 760-969-6560
  • Fax: 760-328-2230
Mailing address:
  • Phone: 760-969-6560
  • Fax: 760-328-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number64062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: