Active NPI
Betty Rose Lee
- Pharmacist
- San Diego, CA
National Provider Identifier
1487134573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023476
- Practice address
- 3350 La Jolla Village Dr
San Diego, CA 92161-0002 - Phone
- (858) 552-8585
- NPI assigned
- Aug 17, 2018
- 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 | S023476 | AZ | Primary |
Addresses
Primary practice location
3350 La Jolla Village Dr
San Diego, CA 92161-0002
Mailing address
4036 Camino Calma
San Diego, CA 92122-2007
Phone (520) 762-4944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S023476 | Other | AZ | PHARMACIST LICENSE |
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 |
|---|---|---|---|
| S023476 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534464000000",
"number": "1487134573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4036 CAMINO CALMA",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921222007",
"telephone_number": "520-762-4944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 LA JOLLA VILLAGE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921610002",
"telephone_number": "858-552-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BETTY",
"middle_name": "ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-17",
"last_updated": "2018-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023476",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "S023476",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.