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NPI Code Detail

MEDICARE: DR. LESLIE NGUYEN PHARMD

MEDICARE: DR. LESLIE NGUYEN PHARMD
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
1183500000XPharmacist72199CA

General Provider Information

NPI Number : 1518496785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE NGUYEN PHARMD
Provider Business Mailing Address
First Line : 7100 BROADWAY
Second Line :
City : LEMON GROVE
State : CA
Zip : 91945-1401
Country : US
Telephone Number : 619-697-3415
Fax Number :
Provider Business Practice Location Address
First Line : 7100 BROADWAY
Second Line :
City : LEMON GROVE
State : CA
Zip : 91945-1401
Country : US
Telephone Number : 619-697-3415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2017
Last Update Date : 07/21/2022

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