=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326320029
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLYN HOANGOANH LE PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2011
-----------------------------------------------------
Last Update Date | 09/19/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 CHESTER AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-5408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-631-2837
-----------------------------------------------------
Fax | 661-631-2983
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8312 EXODUS LN
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93312-6178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-213-3289
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH 56815
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------