Provider Demographics
NPI:1740621507
Name:LUONG, BINH LE (PHARMD)
Entity type:Individual
Prefix:MR
First Name:BINH
Middle Name:LE
Last Name:LUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11655 FRAMES PORT PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6601
Mailing Address - Country:US
Mailing Address - Phone:858-550-9066
Mailing Address - Fax:
Practice Address - Street 1:11655 FRAMES PORT PL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6601
Practice Address - Country:US
Practice Address - Phone:858-550-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist