Provider Demographics
NPI:1396988788
Name:LEE, VINCENT P (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:P
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 AKALANI LOOP
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4121
Mailing Address - Country:US
Mailing Address - Phone:808-222-6450
Mailing Address - Fax:
Practice Address - Street 1:1355 AKALANI LOOP
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4121
Practice Address - Country:US
Practice Address - Phone:808-222-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107138207R00000X
HI15349207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine