Healthcare Provider Details

I. General information

NPI: 1063586568
Provider Name (Legal Business Name): LESTER TSUYOSHI ISERI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 WEST LN
STOCKTON CA
95210-3377
US

IV. Provider business mailing address

7373 WEST LN
STOCKTON CA
95210-3377
US

V. Phone/Fax

Practice location:
  • Phone: 209-476-5478
  • Fax: 209-476-3306
Mailing address:
  • Phone: 209-476-5478
  • Fax: 209-476-3306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH31435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: