Provider Demographics
NPI:1487118253
Name:LEE, JOSH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSH
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9038 BALBOA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-2610
Mailing Address - Country:US
Mailing Address - Phone:818-891-0956
Mailing Address - Fax:818-891-0846
Practice Address - Street 1:9038 BALBOA BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-2610
Practice Address - Country:US
Practice Address - Phone:818-891-0956
Practice Address - Fax:818-891-0846
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist