Provider Demographics
NPI:1407835432
Name:LEE, JANICE M (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 PORTER DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1524
Mailing Address - Country:US
Mailing Address - Phone:925-838-6533
Mailing Address - Fax:925-838-6542
Practice Address - Street 1:200 PORTER DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1524
Practice Address - Country:US
Practice Address - Phone:925-838-6533
Practice Address - Fax:925-838-6542
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC51959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine