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General NPI Number Information
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NPI Number | 1407296742
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Entity Type | Organization
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Legal Business Name | LIFETIME VALUE PHARMACY III, INC.
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 406 W 17TH ST
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City | SANTA ANA
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State | CA
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Zip | 92706-3609
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Country | US
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Telephone | 714-862-2470
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Fax | 714-862-2471
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Provider Business Mailing Address
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Address Line | 406 W 17TH ST
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City | SANTA ANA
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State | CA
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Zip | 92706-3609
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Country | US
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Telephone | 714-862-2470
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Fax | 714-862-2471
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RYAN LINH LE
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Credential |
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Telephone | 714-862-2470
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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 | 51442
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License Number State | CA
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