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NPI Code Detail

MEDICARE: EILEEN YOKE LEE PA-C

MEDICARE: EILEEN YOKE LEE PA-C
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
1363A00000XPhysician AssistantPA14229CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ79046ZOTHERCAFQHC MEDICARE PART B
205-1822OTHERCAFQHC MEDICARE PART A

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4HAP11991FOTHERCAFPACT

General Provider Information

NPI Number : 1306949623
Entity Type Code : Individual
Provider Name (Legal Business Name) : EILEEN YOKE LEE PA-C
Provider Business Mailing Address
First Line : PO BOX 22210
Second Line :
City : OAKLAND
State : CA
Zip : 94623-2210
Country : US
Telephone Number : 510-535-4000
Fax Number : 510-535-4189
Provider Business Practice Location Address
First Line : 1030 INTERNATIONAL BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94606-3730
Country : US
Telephone Number : 510-238-5400
Fax Number : 510-238-5437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 08/05/2013

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Directions to “ EILEEN YOKE LEE PA-C” Practice Location

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