Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A119155 | CA |
NPI | 1285883835 |
---|---|
Provider Name | Dr. Justine C Lee |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-8344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 19/08/2016 |