Healthcare Provider Details

I. General information

NPI: 1093363491
Provider Name (Legal Business Name): KRISTIN LEE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33975 DATE PALM DR
CATHEDRAL CITY CA
92234-4736
US

IV. Provider business mailing address

PO BOX 3061
RANCHO CUCAMONGA CA
91729-3061
US

V. Phone/Fax

Practice location:
  • Phone: 760-202-3533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: