Healthcare Provider Details

I. General information

NPI: 1740529593
Provider Name (Legal Business Name): WAYNE KARMAN LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30627 CHIMNEY LN
UNION CITY CA
94587-1645
US

IV. Provider business mailing address

30627 CHIMNEY LN
UNION CITY CA
94587-1645
US

V. Phone/Fax

Practice location:
  • Phone: 510-552-7685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number000000000
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA149030
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: