Provider Demographics
NPI:1265505275
Name:LEE, MONICA K (PHARMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:K
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 HOSPITAL PKWY STE 625
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1141
Mailing Address - Country:US
Mailing Address - Phone:408-972-3562
Mailing Address - Fax:
Practice Address - Street 1:275 HOSPITAL PKWY STE 625
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1141
Practice Address - Country:US
Practice Address - Phone:408-972-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 51190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist