Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G68537 | CA |
NPI | 1033298724 |
---|---|
Provider Name | Paul H. Lee |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Stockton, CA 95204-6005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 13/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G685370 | (05) | CA |
F16277 | (02) |