Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 260997 | NY |
N | 207VX0201X | Gynecologic Oncologist | 260997 | NY |
Y | 207VX0201X | Gynecologic Oncologist | A137492 | CA |
NPI | 1114185923 |
---|---|
Provider Name | Stephen Jae-Jin Lee |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010-3012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 11/11/2020 |