Healthcare Provider Details

I. General information

NPI: 1265625396
Provider Name (Legal Business Name): ALICE LEE MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 HOWARD ST
SAN FRANCISCO CA
94103-2638
US

IV. Provider business mailing address

1380 HOWARD ST
SAN FRANCISCO CA
94103-2638
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-3488
  • Fax: 415-255-3488
Mailing address:
  • Phone: 415-255-3488
  • Fax: 415-252-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number0082031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: