Provider Demographics
NPI:1336134303
Name:LEE, LLOYD JAMES SR (MD)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:JAMES
Last Name:LEE
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 W CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6805
Mailing Address - Country:US
Mailing Address - Phone:209-384-6493
Mailing Address - Fax:
Practice Address - Street 1:1500 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350
Practice Address - Country:US
Practice Address - Phone:866-682-4842
Practice Address - Fax:209-574-1372
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69557207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1336134303Medicaid
TX3497OtherPARKLAND
TX0054824OtherBLUELINK
TX030774601Medicaid
TX0093CUOtherBCBS
TX39305OtherAMERICAID
CA1336134303Medicaid