Provider Demographics
NPI:1053845933
Name:LEONG LEE, LINDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LEONG LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEONG
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1955 COWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6325
Mailing Address - Country:US
Mailing Address - Phone:530-757-4024
Mailing Address - Fax:530-757-4021
Practice Address - Street 1:1955 COWELL BLVD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-6325
Practice Address - Country:US
Practice Address - Phone:530-757-4024
Practice Address - Fax:530-757-4021
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 32866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist