Healthcare Provider Details

I. General information

NPI: 1770566002
Provider Name (Legal Business Name): MARC J. LEFIEF PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10681 E HIGHWAY 26
STOCKTON CA
95215-9579
US

IV. Provider business mailing address

10681 E HIGHWAY 26
STOCKTON CA
95215-9579
US

V. Phone/Fax

Practice location:
  • Phone: 209-461-5486
  • Fax: 209-461-6890
Mailing address:
  • Phone: 209-461-5486
  • Fax: 209-461-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36831
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number36831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: