Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G73421 | CA |
NPI | 1033316682 |
---|---|
Provider Name | James J Lee |
First Address | Fullerton, CA 92835-3653 |
Second Address | Fullerton, CA 92835-3653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 20/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G47905 | (02) | CA |