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General NPI Number Information
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NPI Number | 1144520032
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Entity Type | Individual
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Provider Name | CLARENCE MARCUS LEE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 6125 PASEO DEL NORTE STE 130
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City | CARLSBAD
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State | CA
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Zip | 92011-1119
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Country | US
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Telephone | 442-244-8347
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Fax | 760-683-0470
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Provider Business Mailing Address
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Address Line | 6125 PASEO DEL NORTE STE 130
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City | CARLSBAD
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State | CA
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Zip | 92011-1119
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Country | US
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Telephone | 442-244-8347
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Fax | 760-683-0470
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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 | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | A138879
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A138879
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License Number State | CA
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