Provider Demographics
NPI:1184644734
Name:LEE, HAK SOON (MD)
Entity Type:Individual
Prefix:
First Name:HAK
Middle Name:SOON
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 1:3200 21ST ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3108
Mailing Address - Country:US
Mailing Address - Phone:661-334-1958
Mailing Address - Fax:661-324-4095
Practice Address - Street 1:420 34TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2237
Practice Address - Country:US
Practice Address - Phone:661-327-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33849207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A338490Medicaid
CA00A338490Medicaid
CA00A338494Medicare PIN
CAZZZ21366ZMedicare PIN
CA050049462Medicare PIN
CAZZZ21365ZMedicare PIN
CA00A338492Medicare PIN
CA00A338495Medicare PIN
CAZZZ34009ZMedicare PIN
CAZZZ15999ZMedicare PIN
CA00A338493Medicare PIN
CACD4582Medicare PIN
CAZZZ15998ZMedicare PIN
CAZZZ21367ZMedicare PIN