Provider Demographics
NPI:1831484104
Name:JEE, HONGKEUN (RPH)
Entity Type:Individual
Prefix:
First Name:HONGKEUN
Middle Name:
Last Name:JEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:
Other - Last Name:JEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6001 COFFEE RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-9414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6001 COFFEE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-9414
Practice Address - Country:US
Practice Address - Phone:661-587-5401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH53991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist