Provider Demographics
NPI:1952457723
Name:LEE, PAUL C (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:LEE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-040 KAUHALE ST UNIT 575
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-7224
Mailing Address - Country:US
Mailing Address - Phone:858-525-2885
Mailing Address - Fax:
Practice Address - Street 1:99-040 KAUHALE ST UNIT 575
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-7224
Practice Address - Country:US
Practice Address - Phone:858-525-2885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2432032084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I17963Medicare UPIN