Provider Demographics
NPI:1194028076
Name:MARR, LEONARD KWONG (PHARMD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:KWONG
Last Name:MARR
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 1:7600 HOSPITAL DR STE A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5406
Mailing Address - Country:US
Mailing Address - Phone:916-423-2098
Mailing Address - Fax:916-689-3660
Practice Address - Street 1:7600 HOSPITAL DR STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5406
Practice Address - Country:US
Practice Address - Phone:916-423-2098
Practice Address - Fax:916-689-3660
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH36980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist