Provider Demographics
NPI:1629510698
Name:LEE, LILIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:
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 1:105 N LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2022
Mailing Address - Country:US
Mailing Address - Phone:714-449-9300
Mailing Address - Fax:714-449-9355
Practice Address - Street 1:105 N LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2022
Practice Address - Country:US
Practice Address - Phone:714-449-9300
Practice Address - Fax:714-449-9355
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist