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General NPI Number Information
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NPI Number | 1134610702
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Entity Type | Individual
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Provider Name | MINNA LEE
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Gender | Female
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Dates
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Enumeration Date | 05/19/2018
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 2200 RIVER PLAZA DR
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City | SACRAMENTO
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State | CA
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Zip | 95833-4134
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Country | US
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Telephone | 669-249-8653
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 RIVER PLAZA DR
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City | SACRAMENTO
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State | CA
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Zip | 95833-4134
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Country | US
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Telephone |
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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 | 0022207
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 063524
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 78237
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License Number State | CA
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