Provider Demographics
NPI:1144397852
Name:LEE, SUN HI (MD)
Entity Type:Individual
Prefix:
First Name:SUN
Middle Name:HI
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 1:2317 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3503
Mailing Address - Country:US
Mailing Address - Phone:661-323-5484
Mailing Address - Fax:661-323-9160
Practice Address - Street 1:2317 17TH STREET
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3503
Practice Address - Country:US
Practice Address - Phone:661-323-5484
Practice Address - Fax:661-323-9160
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38521208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A38521Medicaid
CA5784017OtherPIN
CA5784017OtherPIN
A28643Medicare UPIN