MEDICARE: DR. WONUK 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	207RR0500X	Rheumatology Physician	A77205	CA

General Provider Information

NPI Number	:	1386720092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WONUK LEE M.D.

Provider Business Mailing Address
First Line	:	2419 CASTILLO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4301
Country	:	US
Telephone Number	:	805-682-6363
Fax Number	:	805-682-2287

Provider Business Practice Location Address
First Line	:	2419 CASTILLO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4301
Country	:	US
Telephone Number	:	805-682-6363
Fax Number	:	805-682-2287

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	05/06/2009

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