Provider Demographics
NPI:1639504319
Name:LEE, YONG J (RPH)
Entity Type:Individual
Prefix:
First Name:YONG
Middle Name:J
Last Name:LEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-1916
Mailing Address - Country:US
Mailing Address - Phone:626-357-1818
Mailing Address - Fax:626-357-1168
Practice Address - Street 1:950 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-1916
Practice Address - Country:US
Practice Address - Phone:626-357-1818
Practice Address - Fax:626-357-1168
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61408183500000X
NV13752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist