Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A155554 | CA |
NPI | 1003201922 |
---|---|
Provider Name | Mr. Alexander Sangkyoo Lee |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 24/07/2018 |