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General NPI Number Information
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NPI Number | 1639190028
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Entity Type | Individual
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Provider Name | ROLAND ROBERT LEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | VA MED CENTER/UCSD RADIOLOGY # MC114 3350 LA JOLLA VILLAGE DRIVE
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City | SAN DIEGO
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State | CA
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Zip | 92161-0001
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Country | US
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Telephone | 858-552-8585
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Fax | 858-552-7565
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Provider Business Mailing Address
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Address Line | VA MED CENTER/UCSD RADIOLOGY # MC114 3350 LA JOLLA VILLAGE DRIVE
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City | SAN DIEGO
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State | CA
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Zip | 92161-0001
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Country | US
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Telephone | 858-552-8585
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Fax | 858-552-7565
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G57800
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | G57800
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License Number State | CA
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