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General NPI Number Information
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NPI Number | 1760003057
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Entity Type | Individual
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Provider Name | RICHARD LEE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 812 S GRAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90017-4610
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Country | US
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Telephone | 213-627-7925
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Fax |
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Provider Business Mailing Address
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Address Line | 437 S HILL ST APT 428
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City | LOS ANGELES
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State | CA
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Zip | 90013-2744
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Country | US
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Telephone | 949-870-0454
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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 | 81783
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License Number State | CA
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