Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A130968 | CA |
NPI | 1699013276 |
---|---|
Provider Name | Ruth Lee |
First Address | Fontana, CA 92337-7584 |
Second Address | Fontana, CA 92337-7584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2013 |
Last Update Date | 30/11/2021 |