Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | A65975 | CA |
NPI | 1457361891 |
---|---|
Provider Name | Kuk-Wha Lee |
First Address | Los Angeles, CA 90095-3075 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 09/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A659750 | (05) | CA |
GR0053510 | (05) | CA |
H59227 | (02) | CA |