Provider Demographics
NPI:1447533997
Name:SORENSEN, DAVID LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:SORENSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1577 GEMTOWN CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5019
Mailing Address - Country:US
Mailing Address - Phone:775-291-8688
Mailing Address - Fax:
Practice Address - Street 1:3495 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4503
Practice Address - Country:US
Practice Address - Phone:775-824-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist