Healthcare Provider Details

I. General information

NPI: 1609257864
Provider Name (Legal Business Name): JAIMIE LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2015
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 SUTTER ST STE 105
SAN FRANCISCO CA
94109-5465
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 415-379-9823
  • Fax:
Mailing address:
  • Phone: 510-204-3977
  • Fax: 510-204-5429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA159233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: