Healthcare Provider Details

I. General information

NPI: 1710041421
Provider Name (Legal Business Name): SOO MEI LEE AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUVY LEE AU.D., CCC-A

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 GEARY BLVD FL 1
SAN FRANCISCO CA
94118-3118
US

IV. Provider business mailing address

4141 GEARY BLVD FL 1
SAN FRANCISCO CA
94118-3118
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-8222
  • Fax: 415-833-8444
Mailing address:
  • Phone: 415-833-8222
  • Fax: 415-833-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU2363
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: