Healthcare Provider Details

I. General information

NPI: 1336913094
Provider Name (Legal Business Name): RACHEL N LEE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 11/13/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74710 HWY 111 SUITE 102
PALM DESSERT CA
92260
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:
Mailing address:
  • Phone: 707-666-1510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: RACHEL N LEE
Title or Position: OWNER
Credential: MD
Phone: 707-666-1510