Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | A72757 | CA |
NPI | 1073678454 |
---|---|
Provider Name | Dr. Henry Chong Lee |
First Address | Foster City, CA 94404-2920 |
Second Address | Palo Alto, CA 94304-1507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H69425 | (02) | CA |