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NPI Code Detail

MEDICARE: ALLISON LEE SOU

MEDICARE: ALLISON LEE SOU
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
1183500000XPharmacist89488CA

General Provider Information

NPI Number : 1750104048
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON LEE SOU
Provider Business Mailing Address
First Line : 1515 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3403
Country : US
Telephone Number : 626-962-3685
Fax Number : 626-962-3686
Provider Business Practice Location Address
First Line : 1515 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3403
Country : US
Telephone Number : 626-962-3685
Fax Number : 626-962-3686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2024
Last Update Date : 08/05/2025

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Directions to “ ALLISON LEE SOU ” Practice Location

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