Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 20A12619 | CA |
NPI | 1235421504 |
---|---|
Provider Name | Dr. Monika Lee |
First Address | Los Angeles, CA 90034-9521 |
Second Address | Northridge, CA 91325-4107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 22/10/2021 |