Healthcare Provider Details

I. General information

NPI: 1861189169
Provider Name (Legal Business Name): RACHEL N LEE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74710 HIGHWAY 111 STE 102
PALM DESERT CA
92260-3820
US

IV. Provider business mailing address

2221 N CARDILLO AVE
PALM SPRINGS CA
92262-2828
US

V. Phone/Fax

Practice location:
  • Phone: 833-202-0998
  • Fax: 760-548-3463
Mailing address:
  • Phone: 707-666-1510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: RACHEL NICOLE LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 707-666-1510