Provider Demographics
NPI:1326165366
Name:RICHARD D LEE, MD INC.
Entity Type:Organization
Organization Name:RICHARD D LEE, MD INC.
Other - Org Name:HOMETOWN HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-289-0110
Mailing Address - Street 1:605 COWPER ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1808
Mailing Address - Country:US
Mailing Address - Phone:650-289-0110
Mailing Address - Fax:
Practice Address - Street 1:605 COWPER ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1808
Practice Address - Country:US
Practice Address - Phone:650-289-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF01601Medicare UPIN