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General NPI Number Information
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NPI Number | 1033682471
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Entity Type | Individual
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Provider Name | CHARLES LEE
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Gender | Male
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 7535 N PALM AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93711-5504
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Country | US
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Telephone | 800-797-3543
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Fax |
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Provider Business Mailing Address
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Address Line | 7244 SEPULVEDA BLVD
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City | VAN NUYS
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State | CA
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Zip | 91405-2005
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Country | US
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Telephone | 818-645-5938
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 80053
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License Number State | CA
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