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NPI Code Detail

MEDICARE: JOEL THOMAS LEU R.PH.

MEDICARE: JOEL THOMAS LEU R.PH.
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
1183500000XPharmacist51435CA
2183500000XPharmacist12317WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151435OTHERCAPHARMACY LICENSE

General Provider Information

NPI Number : 1841334257
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL THOMAS LEU R.PH.
Provider Business Mailing Address
First Line : 321 DUNCAN ST # A
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94131-2021
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1607 SHATTUCK AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94709-1611
Country : US
Telephone Number : 510-549-9201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2007
Last Update Date : 07/08/2007

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