Healthcare Provider Details

I. General information

NPI: 1629257035
Provider Name (Legal Business Name): CHRISTOPHER E LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SUPERIOR AVE STE 290
NEWPORT BEACH CA
92663-3667
US

IV. Provider business mailing address

PO BOX 2433
SUISUN CITY CA
94585-5433
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-6244
  • Fax: 949-645-4824
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA95761
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA95761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: