Healthcare Provider Details

I. General information

NPI: 1700557006
Provider Name (Legal Business Name): ANGELA LEE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2021
Last Update Date: 09/26/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

800 INDIANA ST APT 529
SAN FRANCISCO CA
94107-2886
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1000
  • Fax:
Mailing address:
  • Phone: 818-800-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number80779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: