Provider Demographics
NPI:1851798821
Name:LE, JULIENNE DINH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIENNE
Middle Name:DINH
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TIEUPHUONG
Other - Middle Name:DINH
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13901 NADIA WAY
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3623
Mailing Address - Country:US
Mailing Address - Phone:714-837-4499
Mailing Address - Fax:
Practice Address - Street 1:255 N EL CIELO RD
Practice Address - Street 2:SUITE C-322
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6992
Practice Address - Country:US
Practice Address - Phone:760-969-6560
Practice Address - Fax:760-328-2230
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist