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General NPI Number Information
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NPI Number | 1518380609
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Entity Type | Individual
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Provider Name | GLORIA LEE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 103 W AMERICAN CANYON RD
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-1112
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Country | US
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Telephone | 707-649-5160
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Fax | 707-649-5166
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Provider Business Mailing Address
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Address Line | 704 FALCON CT
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City | RICHMOND
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State | CA
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Zip | 94806-1849
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Country | US
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Telephone | 510-725-5782
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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 | RPH 69494
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License Number State | CA
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