Provider Demographics
NPI:1790094712
Name:DE LEONARDIS, ROSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:
Last Name:DE LEONARDIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 N. VERMONT AVE.
Mailing Address - Street 2:RITE AID PHARMACY #5435
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:909-597-3658
Mailing Address - Fax:
Practice Address - Street 1:1533 N VERMONT AVE
Practice Address - Street 2:RITE AID PHARMACY #5435
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5330
Practice Address - Country:US
Practice Address - Phone:909-597-3658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist