Provider Demographics
NPI:1255340311
Name:LEE, ALICE (MD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7601 STONERIDGE DR.
Mailing Address - Street 2:DERMATOLOGY
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:508-485-7779
Mailing Address - Fax:508-485-7769
Practice Address - Street 1:7601 STONERIDGE DR.
Practice Address - Street 2:DERMATOLOGY
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:925-847-5090
Practice Address - Fax:508-485-7769
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
CAC54000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H94563Medicare UPIN