Provider Demographics
NPI:1013014968
Name:LEE, MARGARET MAE (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MAE
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 CORTE MORERA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8246
Mailing Address - Country:US
Mailing Address - Phone:760-436-6581
Mailing Address - Fax:
Practice Address - Street 1:410 S MELROSE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6642
Practice Address - Country:US
Practice Address - Phone:760-806-4355
Practice Address - Fax:760-806-4363
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA797682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA79768AOtherPPIN
CAH17130Medicare UPIN