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General NPI Number Information
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NPI Number | 1861141152
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Entity Type | Individual
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Provider Name | GRACE LEE MD
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Gender | Female
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1 HOAG DR
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4162
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Country | US
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Telephone | 877-742-4624
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 BIRCH ST STE 4700
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2187
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A188829
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License Number State | CA
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