Healthcare Provider Details

I. General information

NPI: 1568875862
Provider Name (Legal Business Name): MAY NA VUE LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W SHAW AVE STE 103
FRESNO CA
93711-3307
US

IV. Provider business mailing address

2501 W SHAW AVE STE 103
FRESNO CA
93711-3307
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-1680
  • Fax: 559-221-4336
Mailing address:
  • Phone: 559-221-1680
  • Fax: 559-221-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: