Provider Demographics
NPI:1225100035
Name:LEE, SONIA (MD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:S LEE
Other - Last Name:HA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3285 CLAREMONT WAY
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3313
Mailing Address - Country:US
Mailing Address - Phone:707-258-2500
Mailing Address - Fax:
Practice Address - Street 1:3285 CLAREMONT WAY
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3313
Practice Address - Country:US
Practice Address - Phone:707-258-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67766208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A677660Medicaid
00A677661Medicare ID - Type Unspecified
H15626Medicare UPIN