MEDICARE: QUAN HOANG 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	RPH 60970	CA

General Provider Information

NPI Number	:	1366729949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUAN HOANG LE PHARM D

Provider Business Mailing Address
First Line	:	1710 S MAIN ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-1836
Country	:	US
Telephone Number	:	714-953-7538
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 S MAIN ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-1836
Country	:	US
Telephone Number	:	714-953-7538
Fax Number	:

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

Provider Enumeration Date	:	11/09/2011
Last Update Date	:	11/01/2014

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