MEDICARE: DON NGUYEN LE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	12751	NV

General Provider Information

NPI Number	:	1043719719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DON NGUYEN LE

Provider Business Mailing Address
First Line	:	9940 ANTELOPE CANYON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9940 ANTELOPE CANYON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7713
Country	:	US
Telephone Number	:	702-919-8899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2018
Last Update Date	:	02/07/2018

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Directions to “ DON NGUYEN LE ” Practice Location

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