Provider Demographics
NPI:1285043364
Name:LE, HAI (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAI
Middle Name:
Last Name:LE
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:PO BOX 580834
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0014
Mailing Address - Country:US
Mailing Address - Phone:916-507-9854
Mailing Address - Fax:
Practice Address - Street 1:6051 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2304
Practice Address - Country:US
Practice Address - Phone:916-427-9731
Practice Address - Fax:916-427-9733
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist