Provider Demographics
NPI:1588032510
Name:DIANA DANTIAN LEE PLLC
Entity Type:Organization
Organization Name:DIANA DANTIAN LEE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-949-9755
Mailing Address - Street 1:503 SIERRA PEAK CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2662
Mailing Address - Country:US
Mailing Address - Phone:916-949-9755
Mailing Address - Fax:702-527-6101
Practice Address - Street 1:503 SIERRA PEAK CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2662
Practice Address - Country:US
Practice Address - Phone:916-949-9755
Practice Address - Fax:702-527-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15282207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty