Healthcare Provider Details

I. General information

NPI: 1053845933
Provider Name (Legal Business Name): LINDA LEONG LEE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA LEONG LEE PHARM.D.

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 COWELL BLVD
DAVIS CA
95618-6325
US

IV. Provider business mailing address

1955 COWELL BLVD
DAVIS CA
95618-6325
US

V. Phone/Fax

Practice location:
  • Phone: 530-757-4024
  • Fax: 530-757-4021
Mailing address:
  • Phone: 530-757-4024
  • Fax: 530-757-4021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 32866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: