Provider Demographics
NPI:1356657548
Name:Y.S. LYNDA LEE, MD INC
Entity Type:Organization
Organization Name:Y.S. LYNDA LEE, MD INC
Other - Org Name:YONG SOOK LYNDA LEE, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MD PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:Y.S.
Authorized Official - Middle Name:LYNDA
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-866-1135
Mailing Address - Street 1:700 W PARR
Mailing Address - Street 2:STE A
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032
Mailing Address - Country:US
Mailing Address - Phone:408-866-1135
Mailing Address - Fax:408-866-7926
Practice Address - Street 1:700 W PARR
Practice Address - Street 2:STE A
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032
Practice Address - Country:US
Practice Address - Phone:408-866-1135
Practice Address - Fax:408-866-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64264207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F73429Medicare UPIN