Provider Demographics
NPI:1750696357
Name:LEE, REGINA S (PHARM D)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 WATT AVENUE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826
Mailing Address - Country:US
Mailing Address - Phone:916-483-9268
Mailing Address - Fax:916-483-7319
Practice Address - Street 1:1730 WATT AVENUE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826
Practice Address - Country:US
Practice Address - Phone:916-483-9268
Practice Address - Fax:916-483-7319
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist