Provider Demographics
NPI:1043634884
Name:LEE, AINAH ROHANI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AINAH
Middle Name:ROHANI
Last Name:LEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 TARTARIAN WAY
Mailing Address - Street 2:NONE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4757
Mailing Address - Country:US
Mailing Address - Phone:408-234-3899
Mailing Address - Fax:888-418-8621
Practice Address - Street 1:1466 TARTARIAN WAY
Practice Address - Street 2:NONE
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4757
Practice Address - Country:US
Practice Address - Phone:408-234-3899
Practice Address - Fax:888-418-8621
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist