Provider Demographics
NPI:1568545374
Name:LEE, LAURA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1180 NORTH INDIAN CANYON WAY
Mailing Address - Street 2:SUITE E218
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-992-7217
Mailing Address - Fax:760-992-7217
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE E218
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-992-7217
Practice Address - Fax:760-992-7217
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG874972086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93080Medicare UPIN