Provider Demographics
NPI:1609248111
Name:PINCE, LEILAN (PHARM D,)
Entity Type:Individual
Prefix:DR
First Name:LEILAN
Middle Name:
Last Name:PINCE
Suffix:
Gender:F
Credentials:PHARM D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23781 MAQUINA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2716
Mailing Address - Country:US
Mailing Address - Phone:949-455-4272
Mailing Address - Fax:
Practice Address - Street 1:23781 MAQUINA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2716
Practice Address - Country:US
Practice Address - Phone:949-455-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist