Provider Demographics
NPI:1518238120
Name:BANH, LE GIA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:LE
Middle Name:GIA
Last Name:BANH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 BELLAIRE AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3418
Mailing Address - Country:US
Mailing Address - Phone:818-392-0481
Mailing Address - Fax:
Practice Address - Street 1:9750 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6422
Practice Address - Country:US
Practice Address - Phone:818-899-9950
Practice Address - Fax:818-899-0223
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist