Provider Demographics
NPI:1699183368
Name:DEAN, LANDON LESLIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LANDON
Middle Name:LESLIE
Last Name:DEAN
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 1:6363 VALLEY SPRINGS PKWY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0905
Mailing Address - Country:US
Mailing Address - Phone:951-653-7850
Mailing Address - Fax:951-656-1746
Practice Address - Street 1:6363 VALLEY SPRINGS PKWY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0905
Practice Address - Country:US
Practice Address - Phone:951-653-7850
Practice Address - Fax:951-656-1746
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2014-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist