Provider Demographics
NPI:1336191634
Name:LEE, CHRISTINE (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1729
Mailing Address - Country:US
Mailing Address - Phone:510-433-0212
Mailing Address - Fax:510-433-0213
Practice Address - Street 1:200 E 18TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1729
Practice Address - Country:US
Practice Address - Phone:510-433-0212
Practice Address - Fax:510-433-0213
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor