Healthcare Provider Details

I. General information

NPI: 1518920602
Provider Name (Legal Business Name): VICTOR W LEE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 CAHALAN AVE 7B
SAN JOSE CA
95123-3010
US

IV. Provider business mailing address

697 E REMINGTON DR STE A
SUNNYVALE CA
94087-1941
US

V. Phone/Fax

Practice location:
  • Phone: 408-227-8281
  • Fax:
Mailing address:
  • Phone: 408-730-0818
  • Fax: 408-735-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE37661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: