Healthcare Provider Details

I. General information

NPI: 1033055124
Provider Name (Legal Business Name): PAULINE JUNE LEW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 720144
SAN DIEGO CA
92172-0144
US

IV. Provider business mailing address

PO BOX 720144
SAN DIEGO CA
92172-0144
US

V. Phone/Fax

Practice location:
  • Phone: 858-405-2959
  • Fax: 858-794-4676
Mailing address:
  • Phone: 858-405-2959
  • Fax: 858-794-4676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number41117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: