Provider Demographics
NPI:1366495574
Name:LEE, TOMMY C (MD)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:C
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3838 SAN DIMAS ST
Mailing Address - Street 2:SUITE B-201
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1456
Mailing Address - Country:US
Mailing Address - Phone:661-321-3161
Mailing Address - Fax:661-321-3166
Practice Address - Street 1:3838 SAN DIMAS ST
Practice Address - Street 2:SUITE B-201
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1456
Practice Address - Country:US
Practice Address - Phone:661-321-3161
Practice Address - Fax:661-321-3166
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG52609207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G526091Medicaid
CAE57849Medicare UPIN
CA00G526091Medicaid