Provider Demographics
NPI:1992721815
Name:KILEY, LELAND MORSE JR (PHARM D)
Entity type:Individual
Prefix:MR
First Name:LELAND
Middle Name:MORSE
Last Name:KILEY
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19271 HILLSDALE DR
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9206
Mailing Address - Country:US
Mailing Address - Phone:209-688-5972
Mailing Address - Fax:
Practice Address - Street 1:1045 MONO WAY
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5282
Practice Address - Country:US
Practice Address - Phone:209-536-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 40983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist