Provider Demographics
NPI:1548506314
Name:SONG, YU LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:YU LEE
Middle Name:
Last Name:SONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 SAWGRASS CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3399
Mailing Address - Country:US
Mailing Address - Phone:909-342-3688
Mailing Address - Fax:909-393-0363
Practice Address - Street 1:1528 E AMAR RD
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1618
Practice Address - Country:US
Practice Address - Phone:626-965-2016
Practice Address - Fax:626-965-5386
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist