Individual provider · Type 1 NPI

Theodore QM Ly

Pharmacist · San Luis Obispo, CA

NPI number 1053980839 Active

Practice location

1251 Johnson Ave
San Luis Obispo, CA 93401-3306

Call (805) 545-0655 Map

Mailing address

1633 W Southgate Ave
Fullerton, CA 92833-3850

Specialties and licenses

TaxonomyCodeLicense
Pharmacist Primary 183500000X84269 (CA)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

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About NPI 1053980839

Theodore QM Ly's National Provider Identifier is 1053980839, issued on Jun 24, 2021. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in San Luis Obispo, CA. The record was last updated on Jun 24, 2021.