Healthcare Provider Details

I. General information

NPI: 1609963982
Provider Name (Legal Business Name): DENNIS LOC VINH LEE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE DEPARTMENT OF PHARMACY
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

1 MAPLE ST APT 2410
REDWOOD CITY CA
94063-1966
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone: 650-568-4351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17244
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: