Provider Demographics
NPI:1780106336
Name:LE, STEPHANIE SHOU-YIN CHIN (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SHOU-YIN CHIN
Last Name:LE
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 1:6309 AMBERGROVE ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-4166
Mailing Address - Country:US
Mailing Address - Phone:661-319-5822
Mailing Address - Fax:
Practice Address - Street 1:30116 EIGENBRODT WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1225
Practice Address - Country:US
Practice Address - Phone:510-675-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA749261835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care