MEDICARE: MS. STEPHANIE VINH-THUY LE PHARM.D

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	183500000X	Pharmacist	RPH52425	CA

General Provider Information

NPI Number	:	1245423755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE VINH-THUY LE PHARM.D

Provider Business Mailing Address
First Line	:	4727 JERRY AVE
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-2437
Country	:	US
Telephone Number	:	626-337-9899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 EASTLAKE AVE RM 1355
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-0112
Country	:	US
Telephone Number	:	323-865-3613
Fax Number	:	323-865-0146

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

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	08/20/2007

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