MEDICARE: CECILE 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	2084P0800X	Psychiatry Physician	4301083508	MI

General Provider Information

NPI Number	:	1508991472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILE LEE M.D.

Provider Business Mailing Address
First Line	:	525 21ST ST
Second Line	:	OAKLAND BEHAVIORAL HEALTH
City	:	OAKLAND
State	:	CA
Zip	:	94612-1605
Country	:	US
Telephone Number	:	510-587-3495
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 21ST ST
Second Line	:	OAKLAND BEHAVIORAL HEALTH
City	:	OAKLAND
State	:	CA
Zip	:	94612-1605
Country	:	US
Telephone Number	:	510-587-3495
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	01/28/2011

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