Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A90704 | CA |
Y | 208600000X | Surgeon | A90704 | CA |
N | 2086X0206X | Surgical Oncologist | A90704 | CA |
NPI | 1134137110 |
---|---|
Provider Name | Dr. Byrne Lee |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 21/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A907040 | (05) | CA |
I35381 | (02) |