MEDICARE: MR. JAMES F. LEE M.D.

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	207Q00000X	Family Medicine Physician	G774160	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GR0078352	OTHER	CA	MEDICAL

General Provider Information

NPI Number	:	1366476970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES F. LEE M.D.

Provider Business Mailing Address
First Line	:	7248 SOUTH LAND PARK DR SUITE 205
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3661
Country	:	US
Telephone Number	:	916-392-4000
Fax Number	:	916-392-7215

Provider Business Practice Location Address
First Line	:	2101 STONE BLVD. SUITE 190
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-4044
Country	:	US
Telephone Number	:	916-371-4939
Fax Number	:	916-371-5401

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/20/2012

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Directions to “ MR. JAMES F. LEE M.D.” Practice Location

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