Provider Demographics
NPI:1780369538
Name:NOLAN LE PHARMD, INC
Entity type:Organization
Organization Name:NOLAN LE PHARMD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:858-610-7501
Mailing Address - Street 1:4425 47TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4516
Mailing Address - Country:US
Mailing Address - Phone:858-208-3688
Mailing Address - Fax:858-201-3835
Practice Address - Street 1:4425 47TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4516
Practice Address - Country:US
Practice Address - Phone:858-208-3688
Practice Address - Fax:858-201-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy