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General NPI Number Information
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NPI Number | 1710113352
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Entity Type | Individual
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Provider Name | BRADFORD WILLIAM LEE M.D., M.SC.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 1380 LUSITANA ST STE 912
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City | HONOLULU
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State | HI
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Zip | 96813-2448
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Country | US
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Telephone | 808-888-9981
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Fax | 808-468-4753
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Provider Business Mailing Address
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Address Line | MSC 61532 P.O. BOX 1300
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City | HONOLULU
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State | HI
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Zip | 96807-1300
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Country | US
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Telephone | 808-888-9981
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MDR-5715
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | TRN 15107
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME124928
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A124892
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD-18295
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License Number State | HI
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