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Healthcare Organization Stored source record

MASON Y. LEE, DDS, A PROFESSIONAL CORP

750 LAS GALLINAS AVE STE 207, SAN RAFAEL, CA, 949033432

atlas:atm_npi_1013305689

Block 3004Block Group 3Census Tract 1082.02Marin CountyCaliforniaUnited States

What is stored

phone
415-472-5040
status
A
address
750 LAS GALLINAS AVE STE 207, SAN RAFAEL, CA, 949033432
fax
415-472-5043
npi
1013305689
license
42929
taxonomy
Clinic/Center, Oral and Maxillofacial Surgery
other names
[]
last updated
2015-01-05
license state
CA
taxonomy code
261QS0112X
all taxonomies
["Clinic/Center, Oral and Maxillofacial Surgery"]
enumeration date
2015-01-05
enumeration type
NPI-2
practice locations
0
authorized official
MASON LEE
organizational subpart
NO

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{
  "fax": "415-472-5043",
  "npi": "1013305689",
  "phone": "415-472-5040",
  "status": "A",
  "address": "750 LAS GALLINAS AVE STE 207, SAN RAFAEL, CA, 949033432",
  "license": "42929",
  "taxonomy": "Clinic/Center, Oral and Maxillofacial Surgery",
  "other_names": [],
  "last_updated": "2015-01-05",
  "license_state": "CA",
  "taxonomy_code": "261QS0112X",
  "all_taxonomies": [
    "Clinic/Center, Oral and Maxillofacial Surgery"
  ],
  "enumeration_date": "2015-01-05",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "MASON LEE",
  "organizational_subpart": "NO"
}