Individual
CHUNG H LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(510) 393-9106
Mailing address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(510) 393-9106
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01055901A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200376120
—
IN
Enumeration date
07/13/2006
Last updated
03/15/2012
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