Provider Demographics
NPI:1922268556
Name:LEE, KEVIN BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BRIAN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:866 CAMPUS DR RM 264
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-8508
Mailing Address - Country:US
Mailing Address - Phone:650-723-3785
Mailing Address - Fax:650-725-2887
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1136
Practice Address - Country:US
Practice Address - Phone:408-261-7777
Practice Address - Fax:408-642-6052
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1113392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry