Provider Demographics
NPI:1578716221
Name:LE, KENNETH NHON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:NHON
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 1:45200 WASHINGTON ST
Mailing Address - Street 2:#334
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2582
Mailing Address - Country:US
Mailing Address - Phone:760-625-4023
Mailing Address - Fax:
Practice Address - Street 1:45200 WASHINGTON ST
Practice Address - Street 2:#334
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2582
Practice Address - Country:US
Practice Address - Phone:760-625-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist