Lee, Phominik T

Lee, Phominik T is an sole proprietor health care provider with primary practice located at 8670 Kelwood Way Same, Sacramento CA 95828-3858. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Driver, Transportation Services / Non-emergency Medical Transport (VAN), Transportation Services / Private Vehicle. Transportation Services / Non-emergency Medical Transport (VAN) is his primary health care specialty. Lee, Phominik T can be contacted via phone (916) 230-8494.

Contact Information

Primary practice address
8670 Kelwood Way Same Sacramento CA 95828-3858
Phone: (916) 230-8494
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X California
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X California
Transportation Services / Private Vehicle 347C00000X California

Profile Details

NPI number 1609043652
LBN Legal business name Lee, Phominik T
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2008
Last updated May 9th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609043652 NPPES
California MEDICAID 99

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