Provider Demographics
NPI:1144867227
Name:DO, JASON LE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:LE
Last Name:DO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 ODYSSEY STE 135
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3193
Mailing Address - Country:US
Mailing Address - Phone:949-387-1133
Mailing Address - Fax:949-387-3310
Practice Address - Street 1:22 ODYSSEY STE 135
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3193
Practice Address - Country:US
Practice Address - Phone:949-387-1133
Practice Address - Fax:949-387-3310
Is Sole Proprietor?:No
Enumeration Date:2019-12-08
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist