Provider Demographics
NPI:1326168477
Name:LEE, CHINFUN ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINFUN
Middle Name:ALLISON
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9700 VILLAGE CENTER DR
Mailing Address - Street 2:STE 50M
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6312
Mailing Address - Country:US
Mailing Address - Phone:916-765-3862
Mailing Address - Fax:
Practice Address - Street 1:9700 VILLAGE CENTER DR STE 50M
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-6312
Practice Address - Country:US
Practice Address - Phone:916-533-1285
Practice Address - Fax:916-292-8077
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA712142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry