Individual
DR. TRAVIS SUNLUM LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546
(510) 727-3256
(510) 727-3107
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 727-3256
(510) 727-3107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A15912
CA
208M00000X
Hospitalist Physician
Primary
20A15912
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A15912
STATE MEDICAL LICENSE
CA
Enumeration date
04/15/2016
Last updated
02/17/2021
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