Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | A34051 | CA |
NPI | 1104806421 |
---|---|
Provider Name | Don W Lee |
First Address | Glendale, CA 91204-4609 |
Second Address | Glendale, CA 91204-4609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 09/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A340510 | (05) | CA |
A88017 | (02) | CA |