1811972524 NPI number — MR. JOSEPH YIU CHO LEE M.A.L.P.

Table of content: MR. JOSEPH YIU CHO LEE M.A.L.P. (NPI 1811972524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811972524 NPI number — MR. JOSEPH YIU CHO LEE M.A.L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEE
Provider First Name:
JOSEPH
Provider Middle Name:
YIU CHO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.A.L.P.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEE
Provider Other First Name:
YIU
Provider Other Middle Name:
CHO
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A.L.P.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1811972524
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 WOODLAND DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURNSVILLE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55337-2707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-203-1207
Provider Business Mailing Address Fax Number:
952-736-2684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1885 UNIVERSITY AVE W
Provider Second Line Business Practice Location Address:
IRISH PARK PLACE SUITE 25
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55104-3489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-203-1207
Provider Business Practice Location Address Fax Number:
952-736-2684
Provider Enumeration Date:
12/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  LP1967 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HP27354 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 62-22021 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 56766LE . This is a "BLUE CROSS BLUE SHIELD MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: A75997205244 . This is a "PREFERREDONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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