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General NPI Number Information
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NPI Number | 1013205681
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Entity Type | Individual
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Provider Name | LESLIE NICOLE BOHNER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 1852 LOMITA BLVD SUITE 204
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City | LOMITA
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State | CA
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Zip | 90717-1968
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Country | US
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Telephone | 310-539-1750
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Fax | 310-539-1734
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Provider Business Mailing Address
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Address Line | 1852 LOMITA BLVD SUITE 204
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City | LOMITA
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State | CA
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Zip | 90717-1968
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Country | US
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Telephone | 310-539-1750
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Fax | 310-539-1734
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 66208
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License Number State | CA
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