Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A74722 | CA |
NPI | 1003865841 |
---|---|
Provider Name | Dr. Chai Sue Lee |
First Address | Sacramento, CA 95816-3300 |
Second Address | Sacramento, CA 95816-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I13343 | (02) | CA |