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General NPI Number Information
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NPI Number | 1700239472
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Entity Type | Individual
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Provider Name | CYNTHIA S LEE NP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 4085 GRAND AVE STE 3
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City | CHINO
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State | CA
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Zip | 91710-5438
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Country | US
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Telephone | 909-282-2678
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Fax |
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Provider Business Mailing Address
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Address Line | 24148 DECORAH RD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1411
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Country | US
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Telephone | 951-201-3003
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Fax |
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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 | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 635290
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95002922
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License Number State | CA
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