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NPI Code Detail

MEDICARE: DR. GROVER LEE PHARM.D, BCMCM

MEDICARE: DR. GROVER LEE PHARM.D, BCMCM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist28865CA

General Provider Information

NPI Number : 1063402642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GROVER LEE PHARM.D, BCMCM
Provider Business Mailing Address
First Line : 2217 PLAZA DR
Second Line :
City : ROCKLIN
State : CA
Zip : 95765-4404
Country : US
Telephone Number : 800-872-8276
Fax Number : 916-960-0342
Provider Business Practice Location Address
First Line : 2217 PLAZA DR
Second Line :
City : ROCKLIN
State : CA
Zip : 95765-4404
Country : US
Telephone Number : 800-872-8276
Fax Number : 916-960-0342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 07/08/2007

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