MEDICARE: SANDY Y. 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	207W00000X	Ophthalmology Physician	A67422	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831188341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY Y. LEE M.D.

Provider Business Mailing Address
First Line	:	16500 VENTURA BLVD
Second Line	:	SUITE 250
City	:	ENCINO
State	:	CA
Zip	:	91436-2011
Country	:	US
Telephone Number	:	818-788-9333
Fax Number	:	818-788-9273

Provider Business Practice Location Address
First Line	:	16500 VENTURA BLVD
Second Line	:	SUITE 250
City	:	ENCINO
State	:	CA
Zip	:	91436-2011
Country	:	US
Telephone Number	:	818-788-9333
Fax Number	:	818-788-9273

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	11/30/2021

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