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NPI Code Detail

MEDICARE: SUSAN WEISHENN LEE MD

MEDICARE: SUSAN WEISHENN LEE MD
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
12085R0001XRadiation Oncology PhysicianG84653CA

General Provider Information

NPI Number : 1710983358
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN WEISHENN LEE MD
Provider Business Mailing Address
First Line : 10470 OLD PLACERVILLE RD
Second Line : SUITE 100
City : SACRAMENTO
State : CA
Zip : 95827-2539
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 4001 J ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95819-3626
Country : US
Telephone Number : 916-453-4528
Fax Number : 916-456-5267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 06/04/2015

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