Organization Active NPI

Daniel Lee

  • Community/Retail Pharmacy
  • San Diego, CA
National Provider Identifier
1750412854
Registry record updated May 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY39339 Issued in CA
Legal business name
DANIEL LEE
Practice address
4002 30TH St
San Diego, CA 92104-2602
Phone
(619) 284-8877
Fax
(619) 284-8893
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2009

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

Authorized official

Name
Daniel Lee, PHARMDNPI 1437149192
Title
Owner and Pharmacist
Phone
(619) 284-8877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY39339 CA Primary

Addresses

Primary practice location

4002 30TH St
San Diego, CA 92104-2602

Mailing address

4002 30TH St
San Diego, CA 92104-2602

Other identifiers 2

IdentifierTypeStateIssuer
0503121OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHY393390MedicaidCA

Other names 1

  • FED RX PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

4002 30th St
San Diego, CA 92104
Phone (619) 284-8877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1750412854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 30TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 30TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042602",
            "telephone_number": "619-284-8877",
            "fax_number": "619-284-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL LEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER AND PHARMACIST",
        "authorized_official_telephone_number": "619-284-8877",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY39339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0503121",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY393390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FED RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 18, 2009; 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.