Provider Demographics
NPI:1124257480
Name:LEE, JUNE SIUFONG (MD)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:SIUFONG
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1715 LUNDY AVE
Practice Address - Street 2:SUITE 108-116
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1837
Practice Address - Country:US
Practice Address - Phone:408-573-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50043208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics