Provider Demographics
NPI:1629576756
Name:LEE, CHRISTIAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
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 1:1748 LILIHA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3111
Mailing Address - Country:US
Mailing Address - Phone:808-585-8472
Mailing Address - Fax:
Practice Address - Street 1:1748 LILIHA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3111
Practice Address - Country:US
Practice Address - Phone:808-585-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH2205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist