Individual provider Active NPI

Samson Lee, PHARMD

  • Pharmacist
  • Sacramento, CA
National Provider Identifier
1730932559
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
75965 Issued in CA
Practice address
414 22ND St
Sacramento, CA 95816-3009
Phone
(916) 734-6377
Fax
(916) 734-1484
NPI assigned
Apr 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 75965 CA Primary

Addresses

Primary practice location

414 22ND St
Sacramento, CA 95816-3009

Mailing address

2420 Stockton Blvd Ste 2000
Sacramento, CA 95817-2206
Phone (916) 734-6377

Other practice location 1

2420 Stockton Blvd Ste 2000
Sacramento, CA 95817-2206
Phone (916) 734-6377

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
75965CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1730932559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 STOCKTON BLVD STE 2000",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172206",
            "telephone_number": "916-734-6377",
            "fax_number": "916-734-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 22ND ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163009",
            "telephone_number": "916-734-6377",
            "fax_number": "916-734-1484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 Stockton Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172206",
            "country_code": "US",
            "telephone_number": "916-734-6377",
            "fax_number": "916-734-1484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SAMSON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "75965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.

Verify at the official NPI Registry.