Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A114709 | CA |
NPI | 1245477280 |
---|---|
Provider Name | Dr. Jerome Lee |
First Address | Los Angeles, CA 90073-1003 |
Second Address | Los Angeles, CA 90073-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2009 |
Last Update Date | 20/01/2022 |