Provider Demographics
NPI:1750659389
Name:LEGGE-BEEKMAN, MARJOLEIN (PHARMD, PHD)
Entity Type:Individual
Prefix:
First Name:MARJOLEIN
Middle Name:
Last Name:LEGGE-BEEKMAN
Suffix:
Gender:F
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 KENYON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5003
Mailing Address - Country:US
Mailing Address - Phone:619-223-5404
Mailing Address - Fax:
Practice Address - Street 1:3405 KENYON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5003
Practice Address - Country:US
Practice Address - Phone:619-223-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-10
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH61344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist