Provider Demographics
NPI:1841527611
Name:LE, THUCDOAN T (PHARMD)
Entity type:Individual
Prefix:
First Name:THUCDOAN
Middle Name:T
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 1:30116 EIGENBRODT WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1225
Mailing Address - Country:US
Mailing Address - Phone:510-248-5204
Mailing Address - Fax:510-675-5095
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:510-248-5204
Practice Address - Fax:510-675-5095
Is Sole Proprietor?:No
Enumeration Date:2009-11-15
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 62782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist