MEDICARE: DR. LINDA 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
1	207Q00000X	Family Medicine Physician	A78555	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1336188838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA LEE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12209
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92423-2209
Country	:	US
Telephone Number	:	909-335-4188
Fax Number	:

Provider Business Practice Location Address
First Line	:	10431 LEMON AVE STE N
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91737-3766
Country	:	US
Telephone Number	:	909-822-2323
Fax Number	:

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/23/2020

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Directions to “ DR. LINDA LEE M.D.” Practice Location

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