Provider Demographics
NPI:1205902855
Name:LEE, STEPHEN S (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 FOAM ST STE 28
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1486
Mailing Address - Country:US
Mailing Address - Phone:831-372-3228
Mailing Address - Fax:831-372-2328
Practice Address - Street 1:284 FOAM ST STE 28
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-1486
Practice Address - Country:US
Practice Address - Phone:831-372-3228
Practice Address - Fax:831-372-2328
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44995207N00000X, 207NS0135X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA449951Medicare ID - Type Unspecified
CAF81820Medicare UPIN