Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A118069 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | A118069 | CA |
NPI | 1063771970 |
---|---|
Provider Name | Lydia Chia-Yi Lee |
First Address | Fountain Valley, CA 92708-4045 |
Second Address | Fountain Valley, CA 92708-4045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2012 |
Last Update Date | 24/06/2020 |