Provider Demographics
NPI:1356501100
Name:LEE, DONG HEUN (MD)
Entity Type:Individual
Prefix:DR
First Name:DONG HEUN
Middle Name:
Last Name:LEE
Suffix:
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 1:513 PARNASSUS AVE STE S380
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2205
Mailing Address - Country:US
Mailing Address - Phone:415-502-1811
Mailing Address - Fax:415-476-9364
Practice Address - Street 1:513 PARNASSUS AVE STE S380
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2205
Practice Address - Country:US
Practice Address - Phone:415-476-9362
Practice Address - Fax:415-476-9364
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC168056207R00000X, 207RI0200X
PAMD432759207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine