MEDICARE: DR. DARRYL TODD LEONG PHARM.D., PH.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	46728	CA

General Provider Information

NPI Number	:	1386926673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRYL TODD LEONG PHARM.D., PH.D

Provider Business Mailing Address
First Line	:	300 MONTGOMERY STREET
Second Line	:	ATTN: WALGREEN PHARMACY
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94014
Country	:	US
Telephone Number	:	415-788-2984
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 MONTGOMERY ST
Second Line	:	ATTN: WALGREEN PHARMACY
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-1902
Country	:	US
Telephone Number	:	415-788-2984
Fax Number	:

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

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	09/13/2011

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