Provider Demographics
NPI:1891669438
Name:SY, MA ANNELEE (RPH)
Entity type:Individual
Prefix:
First Name:MA ANNELEE
Middle Name:
Last Name:SY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 W MISSION RD APT A
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2441
Mailing Address - Country:US
Mailing Address - Phone:805-231-7784
Mailing Address - Fax:
Practice Address - Street 1:232 W MISSION RD APT A
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2441
Practice Address - Country:US
Practice Address - Phone:805-231-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82921333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy