MEDICARE: KAINI LEE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	60227	CA

General Provider Information

NPI Number	:	1013293307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAINI LEE PHARMD

Provider Business Mailing Address
First Line	:	8232 SUNSET ROSE DR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-7317
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3320 CHINO HILLS PKWY
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-4228
Country	:	US
Telephone Number	:	909-393-9056
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2011
Last Update Date	:	10/31/2011

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