Individual
DR. SANG DAE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2095 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4834
(909) 882-3800
(909) 882-3380
Mailing address
467 REDTAIL DR, BREA, CA 92823-1040
(909) 882-3800
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4416
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E44161
—
CA
05
—
0253335
—
CA
01
—
P00147789
RAILROAD
CA
Enumeration date
08/08/2006
Last updated
09/11/2009
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