Healthcare Provider Details

I. General information

NPI: 1063633295
Provider Name (Legal Business Name): JULIE I DEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 WEBBER ST
THE DALLES OR
97058-3749
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 541-769-0426
  • Fax:
Mailing address:
  • Phone: 714-347-1010
  • Fax: 714-647-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA114219
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD157727
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: