Provider Demographics
NPI:1609187350
Name:LEE, DAVID (PHARM D)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LEE
Suffix:
Gender:M
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 1:6931 E WILLIAMS CIR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-5121
Mailing Address - Country:US
Mailing Address - Phone:714-281-1591
Mailing Address - Fax:
Practice Address - Street 1:1528 E AMAR RD
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1618
Practice Address - Country:US
Practice Address - Phone:626-965-2016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist