Provider Demographics
NPI:1770868648
Name:LEE, OK-SUN (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:OK-SUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1354 KELLER LN
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-6428
Mailing Address - Country:US
Mailing Address - Phone:530-876-8222
Mailing Address - Fax:530-876-8035
Practice Address - Street 1:7576 SKYWAY
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3233
Practice Address - Country:US
Practice Address - Phone:530-876-8222
Practice Address - Fax:530-876-8035
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist