Basic Information
| Provider Information | |||||||||
| NPI: | 1326176405 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | ISABEL | ||||||||
| MiddleName: | DEMOS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030 INTERNATIONAL BLVD | ||||||||
| Address2: | SAN ANTONIO NEIGHBORHOOD HEALTH CENTER | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102385416 | ||||||||
| FaxNumber: | 5102385437 | ||||||||
| Practice Location | |||||||||
| Address1: | 1030 INTERNATIONAL BLVD | ||||||||
| Address2: | SAN ANTONIO NEIGHBORHOOD HEALTH CENTER | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102385416 | ||||||||
| FaxNumber: | 5102385437 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 08/18/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A93882 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.