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General NPI Number Information
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NPI Number | 1235120734
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Entity Type | Individual
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Provider Name | NANCY LEE-HATA MD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 12100 EUCLID ST
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City | GARDEN GROVE
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State | CA
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Zip | 92840-3304
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Country | US
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Telephone | 714-741-3665
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Fax | 714-741-3660
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Provider Business Mailing Address
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Address Line | 7547 SHADY GLEN CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-6818
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Country | US
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Telephone | 949-233-8897
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Fax | 714-741-3660
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A87025
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License Number State | CA
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