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General NPI Number Information
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NPI Number | 1972902492
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Entity Type | Individual
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Provider Name | SUN JUNG LEE
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Gender | Female
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1411 LINCOLN BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90401-2732
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Country | US
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Telephone | 310-319-1318
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Fax |
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Provider Business Mailing Address
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Address Line | 115 ELMIRA LN
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5882
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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 | 22363
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License Number State | MD
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