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NPI 1851876122

NPI 1851876122 : JAMIE LEE DO : SIERRA VISTA, AZ

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General NPI Number Information
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    NPI Number           |    1851876122
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    Entity Type          |    Individual 
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    Provider Name        |    JAMIE LEE DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/02/2018
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    Last Update Date     |    03/26/2024
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Provider Practice Location Address
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    Address Line         |    5700 E HIGHWAY 90 
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    City                 |    SIERRA VISTA
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    State                |    AZ
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    Zip                  |    85635-9110
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    Country              |    US
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    Telephone            |    520-263-3161
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    975 53RD ST APT 4 
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    City                 |    OAKLAND
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    State                |    CA
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    Zip                  |    94608-3135
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    Country              |    US
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    Telephone            |    
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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        |    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 |    AZ
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