Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 139429 | CA |
Y | 208600000X | Surgeon | 139429 | CA |
N | 2086S0102X | Surgical Critical Care | 139429 | CA |
N | 2086S0127X | Trauma Surgeon | 139429 | CA |
NPI | 1023339371 |
---|---|
Provider Name | Lung-Ching Lee |
First Address | Arcadia, CA 91006-5229 |
Second Address | Moreno Valley, CA 92555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 01/06/2018 |