Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | A87978 | CA |
NPI | 1427032630 |
---|---|
Provider Name | Dr. John Soyle Lee |
First Address | Sacramento, CA 95827-2539 |
Second Address | Sacramento, CA 95816-5616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 22/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H73718 | (02) | CA |