Provider Demographics
NPI:1518056456
Name:LEE, CONNIE K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
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 1:4131 GEARY BLVD
Mailing Address - Street 2:B-25 ANTICOAGULATION CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-833-4293
Mailing Address - Fax:415-833-2586
Practice Address - Street 1:4131 GEARY BLVD
Practice Address - Street 2:B-25 ANTICOAGULATION CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-833-4293
Practice Address - Fax:415-833-2586
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist