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NPI Code Detail

MEDICARE: DR. JOON HAK EDMUND LEE M.D.

MEDICARE:  DR. JOON HAK EDMUND LEE  M.D.
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
12085B0100XBody Imaging PhysicianG84459CA
22085R0202XDiagnostic Radiology PhysicianG84459CA
32085U0001XDiagnostic Ultrasound PhysicianG84459CA

General Provider Information

NPI Number : 1215933874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOON HAK EDMUND LEE M.D.
Provider Business Mailing Address
First Line : 10470 OLD PLACERVILLE RD
Second Line : SUITE 100
City : SACRAMENTO
State : CA
Zip : 95827-2539
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 3161 L ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-5234
Country : US
Telephone Number : 916-453-9999
Fax Number : 916-739-1099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/29/2015

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