Healthcare Provider Details
I. General information
NPI: 1861564643
Provider Name (Legal Business Name): HENRY HLA HPAY LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1701 OCEAN AVE
SAN FRANCISCO CA
94112-1727
US
IV. Provider business mailing address
1701 OCEAN AVE
SAN FRANCISCO CA
94112-1727
US
V. Phone/Fax
- Phone: 415-452-2200
- Fax: 415-334-5712
- Phone: 415-452-2200
- Fax: 415-334-5712
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A52448 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: