Individual
GORDON KWANLYP LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PASTEUR DR, PALO ALTO, CA 94304-2203
(650) 723-4000
Mailing address
300 PASTEUR DR, PALO ALTO, CA 94304-2203
(650) 723-4000
(650) 725-6605
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A68322
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
A68322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151752-03
CSHCN
TX
05
—
1591752-03
—
TX
01
—
8M7997
BLUE SHIELD
TX
01
—
P00166123
RR/MEDICARE
TX
Enumeration date
03/29/2006
Last updated
04/29/2024
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