Provider Demographics
NPI:1528032570
Name:LEE, MIKE H (MD)
Entity Type:Individual
Prefix:DR
First Name:MIKE
Middle Name:H
Last Name:LEE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-6460
Mailing Address - Fax:619-532-6299
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-6460
Practice Address - Fax:619-532-6299
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IN01053686A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology