Provider Demographics
NPI:1386926673
Name:LEONG, DARRYL TODD (PHARMD, PHD)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:TODD
Last Name:LEONG
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MONTGOMERY STREET
Mailing Address - Street 2:ATTN: WALGREEN PHARMACY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94014
Mailing Address - Country:US
Mailing Address - Phone:415-788-2984
Mailing Address - Fax:
Practice Address - Street 1:300 MONTGOMERY ST
Practice Address - Street 2:ATTN: WALGREEN PHARMACY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-1902
Practice Address - Country:US
Practice Address - Phone:415-788-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist