Healthcare Provider Details

I. General information

NPI: 1477866846
Provider Name (Legal Business Name): NAMJONG SEAN LEE D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 OWENS DR BLDG E2ND
PLEASANTON CA
94588-3900
US

IV. Provider business mailing address

5820 OWENS DR. BUILDING E, 2ND FLOOR
PLEASANTON CA
94588-3900
US

V. Phone/Fax

Practice location:
  • Phone: 925-737-3785
  • Fax:
Mailing address:
  • Phone: 925-737-3785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: