Provider Demographics
NPI:1679009484
Name:LEE, BUYEAN (RPH)
Entity type:Individual
Prefix:
First Name:BUYEAN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44430 CHALLENGER WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-3205
Mailing Address - Country:US
Mailing Address - Phone:661-940-8311
Mailing Address - Fax:661-940-8381
Practice Address - Street 1:44430 CHALLENGER WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-3205
Practice Address - Country:US
Practice Address - Phone:661-940-8311
Practice Address - Fax:661-940-8381
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist