Healthcare Provider Details
I. General information
NPI: 1922070861
Provider Name (Legal Business Name): SANG LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/05/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
334 S PATTERSON AVE STE 209
SANTA BARBARA CA
93111-2400
US
IV. Provider business mailing address
334 S PATTERSON AVE STE 209
SANTA BARBARA CA
93111-2400
US
V. Phone/Fax
- Phone: 805-563-6560
- Fax:
- Phone: 805-563-6560
- Fax: 805-563-3680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | 2012-01135 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 223794 |
| License Number State | MA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | C151928 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: