Provider Demographics
NPI:1548800329
Name:LE, THUAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:THUAN
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9452 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 1 EAST 312
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-0897
Mailing Address - Country:US
Mailing Address - Phone:858-534-2555
Mailing Address - Fax:
Practice Address - Street 1:9452 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 1 EAST 312
Practice Address - City:LA JULLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0897
Practice Address - Country:US
Practice Address - Phone:858-534-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554361835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist