Provider Demographics
NPI:1356384796
Name:LEE, SANG H (MD)
Entity type:Individual
Prefix:DR
First Name:SANG
Middle Name:H
Last Name:LEE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7000 VILLAGE PKWY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2454
Mailing Address - Country:US
Mailing Address - Phone:408-920-0177
Mailing Address - Fax:408-920-0175
Practice Address - Street 1:175 N JACKSON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1909
Practice Address - Country:US
Practice Address - Phone:408-920-0177
Practice Address - Fax:408-920-0175
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-12-14
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Provider Licenses
StateLicense IDTaxonomies
CAA61812174400000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A618120Medicaid
CA00A618120Medicaid