Provider Demographics
NPI:1760457709
Name:LEE, MAUREEN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1480 SUTTER ST
Mailing Address - Street 2:GROUND FLOOR OFFICE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5451
Mailing Address - Country:US
Mailing Address - Phone:415-567-3136
Mailing Address - Fax:415-567-3126
Practice Address - Street 1:1480 SUTTER ST
Practice Address - Street 2:GROUND FLOOR OFFICE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5451
Practice Address - Country:US
Practice Address - Phone:415-567-3136
Practice Address - Fax:415-567-3126
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE3772213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E37720Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAU22119Medicare UPIN