Active NPI
Grace Lee
- Pharmacist
- Anaheim, CA
National Provider Identifier
1306681846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77790
- Practice address
- 731 S Weir Canyon Rd
Anaheim, CA 92808-1960 - Phone
- (714) 282-8095
- NPI assigned
- Jun 26, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 77790 | CA | Primary |
Addresses
Primary practice location
731 S Weir Canyon Rd
Anaheim, CA 92808-1960
Mailing address
906 S Flintridge Way
Anaheim, CA 92808-2327
Phone (657) 900-6259
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 |
|---|---|---|---|
| 77790 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1306681846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 S FLINTRIDGE WAY",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928082327",
"telephone_number": "657-900-6259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 S WEIR CANYON RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928081960",
"telephone_number": "714-282-8095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "GRACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-26",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "77790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.