Crystine M. Lee, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A65187 Issued in CA

Practice address

1055 Broadway Ste a
Sonoma, CA 95476-7467

Phone

(866) 441-0570

NPI assigned

Oct 1, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prima Medical Foundation

  • Clinic/Center
  • Novato, CA
  • NPI 1811217946
  Medicare reassignment NPD
• Whole Health Weight Loss Institute

  • Surgery Physician
  • Napa, CA
  • NPI 1952823841
  Medicare reassignment
• Prima Medical Group, Inc.

  • Family Medicine Physician
  • San Rafael, CA
  • NPI 1154377489
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1508853896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EAGLE GAP RD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496672",
            "telephone_number": "486-644-1057",
            "fax_number": "707-934-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 BROADWAY STE A",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767467",
            "telephone_number": "866-441-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CRYSTINE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-01",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A65187",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "065187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinton Lane VI, M.D.
• Nancy Large, PHARMD
• Michael B Lash, MD
• Caroline Anne Laurent, D.M.D., M.S.
• Angelique Le Roux
• Margaret Frances Leisz, FNP
• Jarrett Rikio Lew, PA-C
• Susan Maria Lewis Pignataro, M.F.T.
• Michael E. Lipson, M.D.
• Sienna Lish, DPT

• Surgery Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.