Provider Demographics
NPI:1235409665
Name:WUGOFSKI, LEE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:
Last Name:WUGOFSKI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:LEON
Other - Middle Name:
Other - Last Name:WUGOFSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:90 7TH ST
Mailing Address - Street 2:SUITE 4-310
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-6701
Mailing Address - Country:US
Mailing Address - Phone:415-437-8056
Mailing Address - Fax:415-437-8008
Practice Address - Street 1:90 7TH ST
Practice Address - Street 2:SUITE 4-310
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-6701
Practice Address - Country:US
Practice Address - Phone:415-437-8056
Practice Address - Fax:415-437-8008
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52680207R00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine