Basic Information
| Provider Information | |||||||||
| NPI: | 1134564453 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | MING | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, FRCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 ALBERTA AVENUE | ||||||||
| Address2: | |||||||||
| City: | WOODSTOCK | ||||||||
| State: | ONTARIO | ||||||||
| PostalCode: | N4V 1H2 | ||||||||
| CountryCode: | CA | ||||||||
| TelephoneNumber: | 5192905888 | ||||||||
| FaxNumber: | 6042243400 | ||||||||
| Practice Location | |||||||||
| Address1: | 521 PARNASSUS AVE RM C455 | ||||||||
| Address2: | BOX 0648 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154769035 | ||||||||
| FaxNumber: | 4155141532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2013 | ||||||||
| LastUpdateDate: | 04/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A125338 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 86795 | ZZ | N | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.