Provider Demographics
NPI:1316468424
Name:LE, DENISE T
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:T
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 QUIET COVE CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6826
Mailing Address - Country:US
Mailing Address - Phone:714-833-2488
Mailing Address - Fax:714-613-1975
Practice Address - Street 1:1002 N FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-1811
Practice Address - Country:US
Practice Address - Phone:714-881-0012
Practice Address - Fax:714-881-4321
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61368OtherPHARMACIST