Most Relevant Information
Provider Data
| NPI Number: | 1003534132 |
| Provider Name: | SHULAMI PARK LEE NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 95021436 |
Most Important Dates
| Enumeration Date: | 08/15/2022 |
| Last Updated: | 10/03/2024 |
Provider Practice Location
353 H ST
CHULA VISTA
CA
919105501
Practice Location Phone/Fax
| Phone: | 8585528585 |
| Fax: | 8586426325 |
Provider Mailing Location
353 H ST
CHULA VISTA
CA
919105501
Provider Mailing Phone/Fax
| Phone: | 8585528585 |
| Fax: | 8586426325 |