MEDICARE: MRS. KAREN PAULA LEE RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86082403	CA

General Provider Information

NPI Number	:	1013798404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN PAULA LEE RD

Provider Business Mailing Address
First Line	:	2059 LAKERIDGE CIR UNIT 103
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91913-2369
Country	:	US
Telephone Number	:	559-296-6901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1662 MAIN ST STE A
Second Line	:
City	:	RAMONA
State	:	CA
Zip	:	92065-5231
Country	:	US
Telephone Number	:	858-230-4930
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2023
Last Update Date	:	10/11/2023

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