Basic Information
| Provider Information | |||||||||
| NPI: | 1669907325 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5210 THORNCREEK CT | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951351224 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1005 DR. D B TODD JR. BLVD. | ||||||||
| Address2: | OLD HOSP. BLDG., 3RD FLOOR | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372081224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153276168 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2017 | ||||||||
| LastUpdateDate: | 07/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD.41208 | AL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 390200000X | TN | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | MD.41208 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.