Provider Demographics
NPI:1881626752
Name:LEE, JOEY KIT (PHARMD, CDE)
Entity type:Individual
Prefix:DR
First Name:JOEY
Middle Name:KIT
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 S CAMPBELL AVENUE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-7113
Mailing Address - Country:US
Mailing Address - Phone:714-580-9608
Mailing Address - Fax:
Practice Address - Street 1:3414 W. BALL ROAD
Practice Address - Street 2:SUITE L
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3726
Practice Address - Country:US
Practice Address - Phone:714-580-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH503371835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2222-0285OtherCERTIFIED DIABETES EDUCAT