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NPI Code Detail

MEDICARE: DR. SALLY LEE MD, DO

MEDICARE: DR. SALLY LEE MD, DO
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
1207W00000XOphthalmology Physician20A80880CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21285859900OTHERCANPI BUSINESS

General Provider Information

NPI Number : 1457468514
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SALLY LEE MD, DO
Provider Business Mailing Address
First Line : 5965 SEVERIN DR.
Second Line :
City : LA MESA
State : CA
Zip : 91942-3428
Country : US
Telephone Number : 619-583-4295
Fax Number : 619-825-7300
Provider Business Practice Location Address
First Line : 5965 SEVERIN DR.
Second Line :
City : LA MESA
State : CA
Zip : 91942-3428
Country : US
Telephone Number : 619-583-4295
Fax Number : 619-825-7300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 03/29/2023

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Directions to “ DR. SALLY LEE MD, DO” Practice Location

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