Provider Demographics
NPI:1518241397
Name:LE, JASON L (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:L
Last Name:LE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1899 FILLMORE STREET
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115
Mailing Address - Country:US
Mailing Address - Phone:415-771-4603
Mailing Address - Fax:415-771-8516
Practice Address - Street 1:1899 FILLMORE STREET
Practice Address - Street 2:WALGREENS PHARMACY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-771-4603
Practice Address - Fax:415-771-8516
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist