Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A114498 | CA |
NPI | 1134422934 |
---|---|
Provider Name | Raymond Churk-Yin Lee |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2010 |
Last Update Date | 19/10/2020 |