Provider Demographics
NPI:1467739045
Name:LOUIE, CHARLEEN S (PHARM D)
Entity Type:Individual
Prefix:MISS
First Name:CHARLEEN
Middle Name:S
Last Name:LOUIE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2374
Mailing Address - Country:US
Mailing Address - Phone:415-441-5742
Mailing Address - Fax:
Practice Address - Street 1:2100 WEBSTER ST STE 105
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2374
Practice Address - Country:US
Practice Address - Phone:415-441-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist