Provider Demographics
NPI:1417048018
Name:LEE, WORLDSTER S M (M D)
Entity Type:Individual
Prefix:
First Name:WORLDSTER
Middle Name:S M
Last Name:LEE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 LILIHA ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5410
Mailing Address - Country:US
Mailing Address - Phone:808-524-1010
Mailing Address - Fax:808-531-1030
Practice Address - Street 1:1712 LILIHA ST
Practice Address - Street 2:SUITE 400
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5410
Practice Address - Country:US
Practice Address - Phone:808-524-1010
Practice Address - Fax:808-531-1030
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD2229207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03499001Medicaid
HI3867-7OtherHMSA PROVIDER #
HIBDCSFMedicare ID - Type Unspecified
HID36369Medicare UPIN