Provider Demographics
NPI:1497826143
Name:LE, THU TRANG THI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THU TRANG
Middle Name:THI
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4115 AREZZO POINTE LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-4366
Mailing Address - Country:US
Mailing Address - Phone:408-238-1007
Mailing Address - Fax:
Practice Address - Street 1:4115 AREZZO POINTE LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148
Practice Address - Country:US
Practice Address - Phone:408-238-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH53248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist