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General NPI Number Information
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NPI Number | 1477647675
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Entity Type | Organization
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Legal Business Name | KYUNG R. LEE, MD & KESOOK LEE, MD
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2555 OCEAN AVE STE 204
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1645
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Country | US
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Telephone | 415-406-1333
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Fax | 415-406-1337
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Provider Business Mailing Address
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Address Line | 2555 OCEAN AVE STE 204
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1645
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Country | US
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Telephone | 415-406-1333
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Fax | 415-406-1337
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Authorized Official
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Title or Position | SECRETARY
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Name | KESOOK K LEE
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Credential | M.D.
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Telephone | 415-406-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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