Provider Demographics
NPI:1467733709
Name:LEE, SANG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:18 ARBORETUM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3829
Mailing Address - Country:US
Mailing Address - Phone:714-356-2960
Mailing Address - Fax:
Practice Address - Street 1:18 ARBORETUM
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3829
Practice Address - Country:US
Practice Address - Phone:714-356-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist