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General NPI Number Information
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NPI Number | 1780115014
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Entity Type | Individual
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Provider Name | SYDNEY NICOLE LEE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1350 S ORANGE AVE
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City | FRESNO
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State | CA
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Zip | 93702-3463
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Country | US
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Telephone | 559-457-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 955 POWELL AVE SW
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City | RENTON
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State | WA
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Zip | 98057-2908
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Country | US
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Telephone | 425-277-1311
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Fax | 425-277-1566
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3861761
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2019-0838
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD61062332
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A170885
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License Number State | CA
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