MEDICARE: TIEN 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	RPH55424	CA

General Provider Information

NPI Number	:	1245550565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIEN LE PHARM.D

Provider Business Mailing Address
First Line	:	111 N MAIN ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5210
Country	:	US
Telephone Number	:	714-648-0885
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 N MAIN ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5210
Country	:	US
Telephone Number	:	714-648-0885
Fax Number	:

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

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	06/09/2010

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Directions to “ TIEN LE PHARM.D” Practice Location

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