Healthcare Provider Details

I. General information

NPI: 1477259539
Provider Name (Legal Business Name): STEPHEN LEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 CALIFORNIA ST APT 3
SAN FRANCISCO CA
94109-4753
US

IV. Provider business mailing address

1512 CALIFORNIA ST APT 3
SAN FRANCISCO CA
94109-4753
US

V. Phone/Fax

Practice location:
  • Phone: 415-297-8094
  • Fax:
Mailing address:
  • Phone: 415-297-8094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: