Individual
ROBERTA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3536 MENDOCINO AVE STE 200, SANTA ROSA, CA 95403-3634
(707) 573-6166
Mailing address
1017 EL CAMINO REAL # 361, REDWOOD CITY, CA 94063-1691
(650) 759-5520
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G62669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G626690
—
CA
Enumeration date
08/13/2010
Last updated
08/13/2010
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