Provider Demographics
NPI:1154883445
Name:LEE, DANIEL KWANGSUK
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KWANGSUK
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STANFORD NEUROSCIENCE HEALTH CENTER
Mailing Address - Street 2:213 QUARRY ROAD
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-5979
Mailing Address - Country:US
Mailing Address - Phone:650-723-6469
Mailing Address - Fax:650-320-9443
Practice Address - Street 1:STANFORD NEUROSCIENCE HEALTH CENTER
Practice Address - Street 2:213 QUARRY ROAD
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-5979
Practice Address - Country:US
Practice Address - Phone:650-723-6469
Practice Address - Fax:650-320-9443
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program