Provider Demographics
NPI:1144816588
Name:LEE, KWOK LUN (MS, RN, CPNP-PC, PHN)
Entity type:Individual
Prefix:
First Name:KWOK LUN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MS, RN, CPNP-PC, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3704
Mailing Address - Country:US
Mailing Address - Phone:415-706-2545
Mailing Address - Fax:
Practice Address - Street 1:760 8TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3704
Practice Address - Country:US
Practice Address - Phone:415-706-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95174477163W00000X
CA95016117363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse