Healthcare Provider Details

I. General information

NPI: 1841741634
Provider Name (Legal Business Name): ZACHARY E LIEBMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1792 GARNET AVE
SAN DIEGO CA
92109-3350
US

IV. Provider business mailing address

1054 LAW ST APT A
SAN DIEGO CA
92109-2667
US

V. Phone/Fax

Practice location:
  • Phone: 858-483-1489
  • Fax:
Mailing address:
  • Phone: 716-535-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: