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NPI Code Detail

MEDICARE: DR. KEVIN L LEE PHARM. D.

MEDICARE: DR. KEVIN L LEE PHARM. D.
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
1183500000XPharmacistPH-4706HI

General Provider Information

NPI Number : 1063177731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN L LEE PHARM. D.
Provider Business Mailing Address
First Line : 812 19TH AVE
Second Line :
City : HONOLULU
State : HI
Zip : 96816-4504
Country : US
Telephone Number : 808-386-8975
Fax Number :
Provider Business Practice Location Address
First Line : 5156 KALANIANAOLE HWY
Second Line :
City : HONOLULU
State : HI
Zip : 96821-1507
Country : US
Telephone Number : 808-377-9643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2021
Last Update Date : 11/08/2021

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