Provider Demographics
NPI:1831477900
Name:LEE, ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
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 1:1670 TREEHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-5635
Mailing Address - Country:US
Mailing Address - Phone:209-612-0708
Mailing Address - Fax:
Practice Address - Street 1:3250 W GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-8427
Practice Address - Country:US
Practice Address - Phone:209-830-5342
Practice Address - Fax:209-830-5363
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-23
Last Update Date:2011-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist