Healthcare Provider Details

I. General information

NPI: 1679161319
Provider Name (Legal Business Name): CURTIS C LEE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 DAVIS ST
SAN LEANDRO CA
94577-6923
US

IV. Provider business mailing address

777 DAVIS ST
SAN LEANDRO CA
94577-6923
US

V. Phone/Fax

Practice location:
  • Phone: 510-626-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4534
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number83998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: