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General NPI Number Information
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NPI Number | 1871810895
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Entity Type | Individual
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Provider Name | LOAN MONG LE PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 8501 AUBURN BLVD
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-0315
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Country | US
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Telephone | 916-723-6593
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Fax | 916-726-5864
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Provider Business Mailing Address
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Address Line | 3760 MONTEVERDE DR
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City | LINCOLN
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State | CA
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Zip | 95648-7900
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Country | US
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Telephone | 916-524-4261
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 050209
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License Number State | CA
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