Healthcare Provider Details

I. General information

NPI: 1831544733
Provider Name (Legal Business Name): ANDY CHAO HSUAN LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 COYLE AVE STE 200
CARMICHAEL CA
95608-0306
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-536-3665
  • Fax: 916-536-3593
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA151994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: