Provider Demographics
NPI:1528570975
Name:LEE, CHI YOUNG (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHI
Middle Name:YOUNG
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 1:18441 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4201
Mailing Address - Country:US
Mailing Address - Phone:818-996-1000
Mailing Address - Fax:818-342-9032
Practice Address - Street 1:18441 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4201
Practice Address - Country:US
Practice Address - Phone:818-996-1000
Practice Address - Fax:818-342-9032
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist