Healthcare Provider Details

I. General information

NPI: 1114833266
Provider Name (Legal Business Name): JUHA LEE
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: JU LEE

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE
SAN FRANCISCO CA
94143-2203
US

IV. Provider business mailing address

18011 POINT CONCEPTION PL
CERRITOS CA
90703-8754
US

V. Phone/Fax

Practice location:
  • Phone: 858-209-8525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: