JON G. LEE (NPI# 1770661589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770661589 |
| Entity Type | Individual |
| Full Name | JON G. LEE |
| Credential | MD |
| Practice Address |
1721 W Yosemite Ave Manteca CA 95337-5130 |
| Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
| Practice Telephone | 2094762000 |
| Mailing Telephone | 5106256262 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | G78741 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G787410 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013399344 | Jon Lee | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2015-06-23 |
| 1174671028 | Jon Pin Lee | Radiology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2007-01-08 |
| Street Address |
1721 W YOSEMITE AVE |
| City | MANTECA |
| State | CA |
| Zip Code | 95337-5130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942283700 | Elizabeth Ann Cliburn | Family Medicine | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2005-11-26 |
| 1215543202 | Gilberto Rodriguez | Respiratory Therapist, Registered | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2020-09-16 |
| 1649891755 | Athena Bechere | Dietitian, Registered | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2020-04-29 |
| 1841854189 | Kenzi Ellen Mather | Physical Therapist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2019-04-23 |
| 1114498789 | Lisa Michelle Gitthens Moses | Internal Medicine | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2018-12-07 |
| 1578030953 | Edmon Artinyan | Psychologist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2018-10-24 |
| 1902311756 | Lily Victoria Kadosh | Psychologist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-12-01 |
| 1205361474 | Kyle K Kato | Pharmacist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-04-26 |
| 1205361896 | Jeffrey Meath | Pharmacist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-04-21 |
| 1104350743 | Shama Afzal | Pharmacist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-04-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640485 | Shanitta D Hines | Counselor | Victor Community Support Services, 302 Cherry Lane, CA 95337 | 2020-08-19 |
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1225430655 | Elizabeth Julia Ann Tyner | Hearing Instrument Specialist | 1079 Eucalyptus, Suite B, Manteca, CA 95337 | 2014-09-17 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 1053668947 | Roger Cabo Inciong | Physical Therapist | 3652 Rapallo Way, Manteca, CA 95337 | 2012-08-09 |
| 1295997757 | Costco Wholesale Corporation | Pharmacy | 2440 Daniels St, Manteca, CA 95337 | 2008-06-26 |
| 1255474235 | Carmen Catherine Nunes | Marriage & Family Therapist | 1771 Yosemite Ave., Manteca, CA 95337 | 2007-02-15 |
| 1063577062 | Kathy Laverne Barron | Counselor | 1789 W. Yosemite Ave., Sierra Building, 1st Floor, Manteca, CA 95337 | 2006-12-27 |
| 1891853149 | R. Ciccarelli, Dds., R. Joseph, Dds., M. El Farra, Dds., D. Saini, Dds | Dentist | 1507 W. Yosemite, Manteca, CA 95337 | 2006-12-05 |
| 1467528265 | Annie Mathew | Pharmacist | 1777 West Yosemite Ave, Manteca, CA 95337 | 2006-11-27 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952491987 | George R Kunhardt | Obstetrics & Gynecology | 1191 E Yosemite Ave Ste C, Manteca, CA 95336-5071 | 2006-10-13 |
| 1053420489 | Kelly Mah | Obstetrics & Gynecology | 421 E Center St, Manteca, CA 95336-4718 | 2006-08-30 |
| 1942288873 | George C Scott | Obstetrics & Gynecology | 210 N Fremont St, Manteca, CA 95336-4725 | 2005-12-30 |
| 1447543160 | Gail R Joseph | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336-4962 | 2011-05-27 |
| 1366516676 | Yu-yea M. Tzeng | Obstetrics & Gynecology | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2006-11-20 |
| 1477654341 | Kelly Mah, M.d. | Obstetrics & Gynecology | 421 E Center St, Manteca, CA 95336-4718 | 2006-09-25 |
| 1992819957 | Prayuk A. Waran | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336 | 2006-08-18 |
| 1093748006 | Cynthia M Vanata | Obstetrics & Gynecology | 1144 Norman Dr, #104, Manteca, CA 95336-5925 | 2006-07-10 |
| 1831122316 | Athena Medical Center for Women, Inc | Obstetrics & Gynecology | 321 Cherry Ln, Manteca, CA 95337-4355 | 2006-07-08 |
| 1437113065 | Manteca Medical Group, Inc | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336-4962 | 2006-04-12 |
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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.