Active NPI
Bryan Lee
- Pharmacist
- Pomona, CA
National Provider Identifier
1003674789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88706
- Practice address
- 1902 Royalty Dr Ste 110
Pomona, CA 91767-3036 - Phone
- (909) 620-8008
- NPI assigned
- Mar 7, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 88706 | CA | Primary |
Addresses
Primary practice location
1902 Royalty Dr Ste 110
Pomona, CA 91767-3036
Mailing address
11260 Greycliff Ave
Montclair, CA 91763-6436
Phone (808) 255-6053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88706 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1003674789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11260 GREYCLIFF AVE",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917636436",
"telephone_number": "808-255-6053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1902 ROYALTY DR STE 110",
"city": "POMONA",
"state": "CA",
"postal_code": "917673036",
"telephone_number": "909-620-8008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BRYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-07",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "88706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.