Provider Demographics
NPI:1477259539
Name:LEE, STEPHEN
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 CALIFORNIA ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4753
Mailing Address - Country:US
Mailing Address - Phone:415-297-8094
Mailing Address - Fax:
Practice Address - Street 1:1512 CALIFORNIA ST APT 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4753
Practice Address - Country:US
Practice Address - Phone:415-297-8094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171R00000XOther Service ProvidersInterpreter
No172A00000XOther Service ProvidersDriver
No175F00000XOther Service ProvidersNaturopath