Healthcare Provider Details

I. General information

NPI: 1437654530
Provider Name (Legal Business Name): HANNAH H LEE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S SAN MATEO DR STE 302
SAN MATEO CA
94401-3844
US

IV. Provider business mailing address

710 LAWRENCE EXPY DEPT 140
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 650-484-0700
  • Fax: 650-484-4003
Mailing address:
  • Phone: 408-851-1950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE5765
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5765
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE5765
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: