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NPI 1134727431

NPI 1134727431 : LUCY LI PHARMD : HESPERIA, CA

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General NPI Number Information
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    NPI Number           |    1134727431
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    Entity Type          |    Individual 
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    Provider Name        |    LUCY LI PHARMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/09/2020
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    Last Update Date     |    10/09/2020
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Provider Practice Location Address
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    Address Line         |    16330 WALNUT ST # 4 
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    City                 |    HESPERIA
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    State                |    CA
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    Zip                  |    92345-3623
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    Country              |    US
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    Telephone            |    760-205-2120
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5888 PINEGROVE PL 
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    City                 |    EASTVALE
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    State                |    CA
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    Zip                  |    92880-0978
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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       |    80840
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    License Number State |    CA
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