MEDICARE: AMIE OK LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101Y00000X	Counselor		CA

General Provider Information

NPI Number	:	1093842908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIE OK LEE

Provider Business Mailing Address
First Line	:	1633 KLIPSPRINGER DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4752
Country	:	US
Telephone Number	:	408-499-7037
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 TULLY RD
Second Line	:	SUITE 304
City	:	SAN JOSE
State	:	CA
Zip	:	95122-3055
Country	:	US
Telephone Number	:	408-271-3900
Fax Number	:	408-271-3909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/13/2007

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Directions to “ AMIE OK LEE ” Practice Location

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