Provider Demographics
NPI:1922395193
Name:LE, RANDY TU (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:TU
Last Name:LE
Suffix:
Gender:M
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 1:3000 COUNTRYSIDE DR
Mailing Address - Street 2:T1304
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-8402
Mailing Address - Country:US
Mailing Address - Phone:209-632-0370
Mailing Address - Fax:209-632-0370
Practice Address - Street 1:3000 COUNTRYSIDE DR
Practice Address - Street 2:T1304
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-8402
Practice Address - Country:US
Practice Address - Phone:209-632-0370
Practice Address - Fax:209-632-0370
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist