Provider Demographics
NPI:1639683071
Name:KAYE, LILY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:
Last Name:KAYE
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 1:11349 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3032
Mailing Address - Country:US
Mailing Address - Phone:310-699-3635
Mailing Address - Fax:
Practice Address - Street 1:11349 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-3032
Practice Address - Country:US
Practice Address - Phone:310-699-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist