Provider Demographics
NPI:1013570076
Name:LEBEDINSKI, BRIAN HENRY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:HENRY
Last Name:LEBEDINSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 S SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-4202
Mailing Address - Country:US
Mailing Address - Phone:310-478-9821
Mailing Address - Fax:
Practice Address - Street 1:3010 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-4202
Practice Address - Country:US
Practice Address - Phone:310-478-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist