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General NPI Number Information
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NPI Number | 1902442387
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Entity Type | Organization
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Legal Business Name | LEO SALUTEM INC
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Dates
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Enumeration Date | 11/20/2019
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 4575 CAMINO DE LA PLZ STE 106
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City | SAN YSIDRO
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State | CA
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Zip | 92173-3157
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Country | US
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Telephone | 619-407-5555
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Fax | 619-407-6718
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Provider Business Mailing Address
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Address Line | 4575 CAMINO DE LA PLZ STE 106
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City | SAN YSIDRO
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State | CA
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Zip | 92173-3157
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Country | US
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Telephone | 619-407-5555
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Fax | 619-407-6718
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL J LYONS
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Credential | PHARM.D
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Telephone | 619-407-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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