Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A94779 | CA |
NPI | 1609905173 |
---|---|
Provider Name | Dr. Raymond E Lee |
First Address | Newport Beach, CA 92660-9057 |
Second Address | Santa Ana, CA 92707-8706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |