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Individual
EDWARD WAN-JAE LEE
Active
Individual
EDWARD WAN-JAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
49176
MN
207W00000X
Ophthalmology Physician
Primary
A106255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC083Z
MEDICARE INDIV. PTAN
CA
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
01
—
W2067
MEDICARE GROUP PTAN
CA
Enumeration date
05/03/2007
Last updated
01/06/2022
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