Individual
GRACE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
999 SAN BERNARDINO RD, UPLAND, CA 91786-4920
(909) 985-2811
Mailing address
PO BOX 1628, ORANGE, CA 92856-0628
(714) 560-1580
(714) 560-1585
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A61069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A610690
—
CA
Enumeration date
06/16/2006
Last updated
02/19/2015
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