Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A102563 | CA |
Y | 208600000X | Surgeon | A102563 | CA |
N | 208200000X | Surgeon | MD33189 | DC |
N | 208600000X | Surgeon | MD33189 | DC |
N | 2086S0102X | Surgical Critical Care | D0066631 | MD |
NPI | 1073724712 |
---|---|
Provider Name | Dr. Patricia W Lee |
First Address | San Jose, CA 95124-3912 |
Second Address | San Jose, CA 95124-3912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19460039 | CARFISRT BCBS (01) | DC |
413363301 | (05) | MD |
61543001 | CAREFIRST BCBS (01) | MD |
AY109Z | MEDICARE PTAN (01) | CA |