Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | G071856 | CA |
NPI | 1104927615 |
---|---|
Provider Name | Joselyn Carmel Lee |
First Address | Los Angeles, CA 90024-0854 |
Second Address | Long Beach, CA 90807-3440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |