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NPI Code Detail

MEDICARE: GREGORY WOOKOUN LEE M.D.

MEDICARE: GREGORY WOOKOUN 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
1207Q00000XFamily Medicine Physician036-094244IL
2207Q00000XFamily Medicine PhysicianMD10976HI
3207Q00000XFamily Medicine PhysicianC54517CA

General Provider Information

NPI Number : 1649255282
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY WOOKOUN LEE M.D.
Provider Business Mailing Address
First Line : 5256 MILES AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94618-1045
Country : US
Telephone Number : 808-389-2640
Fax Number :
Provider Business Practice Location Address
First Line : 901 NEVIN AVE
Second Line :
City : RICHMOND
State : CA
Zip : 94801-3143
Country : US
Telephone Number : 510-307-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 12/15/2021

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Directions to “ GREGORY WOOKOUN LEE M.D.” Practice Location

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