Provider Demographics
NPI:1528018132
Name:LEE, HERBERT JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:JAMES
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2528 SISTER MARY COLUMBA DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4327
Mailing Address - Country:US
Mailing Address - Phone:530-528-6100
Mailing Address - Fax:530-528-6146
Practice Address - Street 1:2528 SISTER MARY COLUMBA DR
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4327
Practice Address - Country:US
Practice Address - Phone:530-528-6100
Practice Address - Fax:530-528-6146
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26317207RC0000X
CAG55709207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN174325200Medicaid
MN174325200Medicaid
MNF63120Medicare UPIN