Tina Lee Medical Llc | |
4045 E Bell Rd Phoenix AZ 85032-2236 | |
(602) 569-2790 | |
(602) 992-7851 |
Full Name | Tina Lee Medical Llc |
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Speciality | Family Medicine |
Location | 4045 E Bell Rd, Phoenix, Arizona |
Authorized Official Name and Position | Tina Xiang Lee (PRIMARY MEDICAL PROVIDER) |
Authorized Official Contact | 6025692790 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Tina Lee Medical Llc 1716 Arlingate Dr S Upper Arlington OH 43220-3067 Ph: (614) 535-5493 | Tina Lee Medical Llc 4045 E Bell Rd Phoenix AZ 85032-2236 Ph: (602) 569-2790 |
NPI Number | 1255924395 |
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Provider Enumeration Date | 02/19/2021 |
Last Update Date | 02/19/2021 |
Medicare PECOS PAC ID | 4183031990 |
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Medicare Enrollment ID | O20210323001645 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255924395 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Tina X Lee |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982924619 PECOS PAC ID: 1759521842 Enrollment ID: I20210323001704 |
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