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General NPI Number Information
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NPI Number | 1306655584
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Entity Type | Individual
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Provider Name | KEVIN LE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 615 BROADWAY
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City | MILLBRAE
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State | CA
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Zip | 94030-1909
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Country | US
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Telephone | 650-697-0166
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 NOBILI AVE
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City | SANTA CLARA
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State | CA
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Zip | 95051-1400
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Country | US
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Telephone |
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Fax |
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 90622
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License Number State | CA
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