Provider Demographics
NPI:1689858094
Name:CHARLES K. LEE, MD, INC.
Entity Type:Organization
Organization Name:CHARLES K. LEE, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ATTENDING SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-933-8330
Mailing Address - Street 1:1545 PINE ST
Mailing Address - Street 2:UNIT 101
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4682
Mailing Address - Country:US
Mailing Address - Phone:415-933-8330
Mailing Address - Fax:415-933-8292
Practice Address - Street 1:1545 PINE ST.
Practice Address - Street 2:UNIT 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-1078
Practice Address - Country:US
Practice Address - Phone:415-933-8330
Practice Address - Fax:415-933-8292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82918208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty