Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | EL6814 | CA |
NPI | 1083135743 |
---|---|
Provider Name | Danielle Marie Lee |
First Address | Redlands, CA 92373-5352 |
Second Address | Loma Linda, CA 92357-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2017 |
Last Update Date | 03/07/2017 |