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General NPI Number Information
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NPI Number | 1780110114
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Entity Type | Individual
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Provider Name | DEBORAH SAN LEE D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2121 SAN DIEGO AVE
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City | SAN DIEGO
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State | CA
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Zip | 92110-2928
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Country | US
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Telephone | 858-552-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 SAN DIEGO AVE RM 242
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City | SAN DIEGO
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State | CA
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Zip | 92110-2928
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Country | US
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Telephone | 619-497-8475
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 20A16788
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License Number State | CA
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