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General NPI Number Information
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NPI Number | 1023751237
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Entity Type | Individual
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Provider Name | JANE KYUN LEE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 1509 WILSON TER
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City | GLENDALE
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State | CA
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Zip | 91206-4007
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Country | US
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Telephone | 818-409-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 732 W DRYDEN ST APT D
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City | GLENDALE
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State | CA
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Zip | 91202-2163
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Country | US
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Telephone | 818-572-3487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 75629
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License Number State | CA
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