Healthcare Provider Details

I. General information

NPI: 1417800863
Provider Name (Legal Business Name): LOAN LE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 W CHAPMAN AVE
PLACENTIA CA
92870-5705
US

IV. Provider business mailing address

18511 S MARIPOSA AVE
GARDENA CA
90248-4033
US

V. Phone/Fax

Practice location:
  • Phone: 714-592-5691
  • Fax:
Mailing address:
  • Phone: 714-592-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: