Provider Demographics
NPI:1952177867
Name:GRACE LEE, MD, PC
Entity Type:Organization
Organization Name:GRACE LEE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-408-6022
Mailing Address - Street 1:250 KING ST UNIT 700
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-5495
Mailing Address - Country:US
Mailing Address - Phone:512-799-2787
Mailing Address - Fax:
Practice Address - Street 1:250 KING ST UNIT 700
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-5495
Practice Address - Country:US
Practice Address - Phone:512-799-2787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health