Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A89400 | CA |
NPI | 1669622122 |
---|---|
Provider Name | Kimberly J Lee |
First Address | Los Angeles, CA 90025 |
Second Address | Los Angeles, CA 90025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2008 |
Last Update Date | 24/11/2010 |