Basic Information
Provider Information
NPI: 1902861883
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEN
FirstName: LEE-MAY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1635 DIVISADERO ST
Address2: STE 625, BOX 1821
City: SAN FRANCISCO
State: CA
PostalCode: 941430001
CountryCode: US
TelephoneNumber: 4154764029
FaxNumber: 4154764150
Practice Location
Address1: 1600 DIVISADERO ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941430001
CountryCode: US
TelephoneNumber: 4153539600
FaxNumber: 4153537657
Other Information
ProviderEnumerationDate: 04/20/2006
LastUpdateDate: 09/10/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XG83192CAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VX0201XG83192CAY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology

ID Information
IDTypeStateIssuerDescription
00G83192005CA MEDICAID


Home