Individual
DR. SUN IK LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4016 DALE RD, MODESTO, CA 95356-9268
(209) 571-0288
(209) 571-0327
Mailing address
PO BOX 36833, BELFAST, ME 04915-1210
(209) 571-0288
(209) 571-0327
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
27123
NE
207T00000X
Neurological Surgery Physician
Primary
A140655
CA
282N00000X
General Acute Care Hospital
MD. 203337
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437184652
—
NE
Enumeration date
06/01/2012
Last updated
11/08/2023
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