Provider Demographics
NPI:1437487493
Name:CINDY M. LEE, LLC
Entity Type:Organization
Organization Name:CINDY M. LEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:907-561-5007
Mailing Address - Street 1:4100 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5229
Mailing Address - Country:US
Mailing Address - Phone:907-561-5007
Mailing Address - Fax:907-561-5057
Practice Address - Street 1:4100 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 206
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5229
Practice Address - Country:US
Practice Address - Phone:907-561-5007
Practice Address - Fax:907-561-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA2448207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty