Healthcare Provider Details

I. General information

NPI: 1447532155
Provider Name (Legal Business Name): PHOEBE Y LI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

1233 ARIZONA AVE
MILPITAS CA
95035-3217
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-2318
  • Fax: 408-885-5822
Mailing address:
  • Phone: 408-942-7233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: