Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A95245 | CA |
NPI | 1104913425 |
---|---|
Provider Name | Justin Thien Lee |
First Address | Bakersfield, CA 93303-2287 |
Second Address | Bakersfield, CA 93311-9505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 14/10/2021 |