Provider Demographics
NPI:1508841776
Name:LEHMAN, MICHAEL GILBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:GILBERT
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-4683
Mailing Address - Country:US
Mailing Address - Phone:209-832-9633
Mailing Address - Fax:209-832-4691
Practice Address - Street 1:1950 W 11TH ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3738
Practice Address - Country:US
Practice Address - Phone:209-832-5340
Practice Address - Fax:209-832-4691
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist