Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | C142547 | CA |
Y | 208600000X | Surgeon | C142547 | CA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 036116715 | IL |
NPI | 1023028776 |
---|---|
Provider Name | Winnie W Lee |
First Address | Venice, CA 90291-2736 |
Second Address | Calabasas, CA 91302-2973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U35454 | (02) |