Provider Demographics
NPI:1235187345
Name:LEE, CHANHUNG Z (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANHUNG
Middle Name:Z
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ZHANHONG
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 DIVISADERO C355
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-885-7626
Mailing Address - Fax:415-885-7284
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-476-2131
Practice Address - Fax:415-476-9516
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72407207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A7240700Medicaid
CAH64701Medicare UPIN
CA0A7240700Medicare PIN