MR. DOO KWANG LEE (NPI# 1649356163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649356163 |
| Entity Type | Individual |
| Full Name | MR. DOO KWANG LEE |
| Credential | MD |
| Practice Address |
645 W Harding Way Suite 5a Stockton CA 95204 |
| Mailing Address |
11424 Valley Oak Drive Oakdale CA 95361 |
| Practice Telephone | 2099412601 |
| Practice Fax Number | 2099412641 |
| Mailing Telephone | 2098489242 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | A31485 | CA | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | A31485 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A314850 | 05 |
| Street Address |
645 W HARDING WAY SUITE 5A |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427056209 | Yi-po Anthony Wu | Internal Medicine | 645 W Harding Way, Suite 15, Stockton, CA 95204-5688 | 2005-07-14 |
| 1144344136 | Austin Abbott Carpenter Jr. | Psychologist | 645 W Harding Way, Sutie 2, Stockton, CA 95204-5688 | 2007-03-17 |
| 1871532887 | Excell E.n.t. Medical Group, Inc. | Otolaryngology | 645 W Harding Way, Suite 6, Stockton, CA 95204-5688 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154696714 | Henry Bahgat Selim | General Practice | 3279 Lakeshore Court, Stockton, CA 95219-5491 | 2012-03-15 |
| 1295982734 | Guey C Mark M D Inc | General Practice | 1072 W. Monterey Avenue, Stockton, CA 95204-3031 | 2008-08-27 |
| 1306015458 | John Edward Newman IIi | General Practice | 1819 Maude St, Stockton, CA 95206-5709 | 2008-02-22 |
| 1912001363 | Ngac Tien Tran | General Practice | 1545 Saint Marks Plz, Suite 1c, Stockton, CA 95207-6411 | 2006-09-07 |
| 1639187552 | Harbhajan Singh Shergill | General Practice | 5345 N El Dorado, #3, Stockton, CA 95207-5848 | 2006-08-04 |
| 1396720355 | Maynard F. Lang | General Practice | 782 East Harding Way, Stockton, CA 95205-6101 | 2005-12-13 |
| 1932383924 | Toanhungtran Md Inc | General Practice | 4545 Georgetown Pl, C 16, Stockton, CA 95207-6215 | 2007-12-26 |
| 1902955859 | Bradley Donald Tourtlotte | General Practice | 3663 Arch Rd, Suite 400, Stockton, CA 95215-8315 | 2007-01-09 |
| 1164500773 | Toan Hung Tran | General Practice | 4545 Georgetown Pl, C16, Stockton, CA 95207-6215 | 2006-11-01 |
| 1932214517 | Dumrong Jirasut | General Practice | 75 W March Lane, Suite H, Stockton, CA 95207-5729 | 2006-08-21 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.