Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | G041946 | CA |
NPI | 1235247107 |
---|---|
Provider Name | Eugene Way Lee |
First Address | Sacramento, CA 95819-3840 |
Second Address | Sacramento, CA 95819-3840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8730518 | (05) | CA |
A48752 | (02) |