Provider Demographics
NPI:1609951961
Name:LEE, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 LOMAS SANTA FE DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1350
Mailing Address - Country:US
Mailing Address - Phone:858-259-9900
Mailing Address - Fax:858-259-0864
Practice Address - Street 1:530 LOMAS SANTA FE DR STE 4
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1350
Practice Address - Country:US
Practice Address - Phone:858-259-9900
Practice Address - Fax:858-259-0864
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43807207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA43807AMedicare ID - Type Unspecified
E54575Medicare UPIN