Provider Demographics
NPI:1497976385
Name:LEE, PHILBERT MANUEL (DOCTOR OF CHIROPRACT)
Entity Type:Individual
Prefix:MR
First Name:PHILBERT
Middle Name:MANUEL
Last Name:LEE
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
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Mailing Address - Street 1:39275 MISSION BLVD
Mailing Address - Street 2:SUITE #202
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539
Mailing Address - Country:US
Mailing Address - Phone:510-797-2961
Mailing Address - Fax:510-797-2966
Practice Address - Street 1:39275 MISSION BLVD
Practice Address - Street 2:SUITE #202
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539
Practice Address - Country:US
Practice Address - Phone:510-797-2961
Practice Address - Fax:510-797-2966
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC18499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor