Provider Demographics
NPI:1194031864
Name:LEU, SHUFENG (BPHARM)
Entity Type:Individual
Prefix:MR
First Name:SHUFENG
Middle Name:
Last Name:LEU
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 MISSION GORGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2306
Mailing Address - Country:US
Mailing Address - Phone:619-284-3345
Mailing Address - Fax:619-284-6549
Practice Address - Street 1:6505 MISSION GORGE RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2306
Practice Address - Country:US
Practice Address - Phone:619-284-3345
Practice Address - Fax:619-284-6549
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist