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General NPI Number Information
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NPI Number | 1275673824
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Entity Type | Individual
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Provider Name | RICHARD K LEE MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 5 MEDICAL PLAZA DRIVE SUITE 210
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City | ROSEVILLE
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State | CA
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Zip | 95661
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Country | US
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Telephone | 916-780-5477
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Fax |
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Provider Business Mailing Address
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Address Line | 4504 FLORADALE CT
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City | ROCKLIN
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State | CA
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Zip | 95677-4539
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Country | US
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Telephone | 916-780-5477
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Fax | 916-780-5447
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A85022
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A85022
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License Number State | CA
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