Individual
KAO YANG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
6339 MACK RD, SACRAMENTO, CA 95823-4655
(916) 585-7912
(877) 479-7101
Mailing address
200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4317
(916) 585-7912
(877) 479-7101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA20648
CA
363L00000X
Nurse Practitioner
Primary
20882
CA
363L00000X
Nurse Practitioner
NP20882
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EFF 8/12/13-MACK RD
—
CA
05
—
EFF: 8/5/13 MARYSVIL
—
CA
05
—
EFF:8/5/13 55TH ST
—
CA
05
—
EFF:8/5/13 C HEIGHTS
—
CA
05
—
EFF:8/5/13 NORWOOD
—
CA
01
—
P01284201/DS9933
RAILROAD MEDICARE-MACK RD.
CA
01
—
P01453291-DV5277
RAILROAD MEDICARE
CA
Enumeration date
01/07/2010
Last updated
06/18/2015
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