Provider Demographics
NPI:1013904242
Name:MCSTROUL, LEO MT (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEO
Middle Name:MT
Last Name:MCSTROUL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30111 ROLLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4610
Mailing Address - Country:US
Mailing Address - Phone:818-706-3083
Mailing Address - Fax:
Practice Address - Street 1:19631 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3408
Practice Address - Country:US
Practice Address - Phone:818-886-4900
Practice Address - Fax:818-886-2309
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist