Individual
MR. GEORGE ICHUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 SAN PABLO AVE, PINOLE, CA 94564-2068
(510) 724-9500
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G53711
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G537110
BLUE SHIELD OF CA
CA
05
—
00G537110
—
CA
Enumeration date
11/20/2006
Last updated
12/13/2007
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