Provider Demographics
NPI:1053481499
Name:LEE, ANNIE Y (PHARM D)
Entity Type:Individual
Prefix:PROF
First Name:ANNIE
Middle Name:Y
Last Name:LEE
Suffix:
Gender:F
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:KAISER PERMANENTE, 2345 FAIR OAKS BLVD, MEDICINE 6
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3714
Mailing Address - Country:US
Mailing Address - Phone:916-480-6641
Mailing Address - Fax:
Practice Address - Street 1:KAISER PERMANENTE, 2345 FAIR OAKS BLVD, MEDICINE 6
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4708
Practice Address - Country:US
Practice Address - Phone:916-480-6641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 48742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist