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General NPI Number Information
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NPI Number | 1982953766
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Entity Type | Organization
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Legal Business Name | JIN Y. LEE. MD. INC.
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 100 O'CONNOR DR. #12
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-280-5655
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Fax | 408-280-5631
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Provider Business Mailing Address
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Address Line | 100 O'CONNOR DR. #12
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-280-5655
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Fax | 408-280-5631
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MR. JIN Y. LEE
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Credential | M.D.
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Telephone | 408-280-5655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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