Individual
JAIMIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 ASHBY AVE, BERKELEY, CA 94705-2067
(510) 204-3977
(510) 204-5429
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 204-3977
(510) 204-5429
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A159233
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A159233
STATE MEDICAL LICENSE
CA
Enumeration date
06/13/2015
Last updated
02/08/2022
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