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General NPI Number Information
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NPI Number | 1053308197
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Entity Type | Individual
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Provider Name | CALVIN M LEE MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2336 SYLVAN AVE STE C
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City | MODESTO
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State | CA
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Zip | 95355-9294
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Country | US
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Telephone | 209-551-1888
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Fax | 209-551-5662
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Provider Business Mailing Address
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Address Line | PO BOX 578958
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City | MODESTO
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State | CA
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Zip | 95357-8958
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Country | US
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Telephone | 209-551-1888
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Fax | 209-551-5662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A82159
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License Number State | CA
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