Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | A161616 | CA |
NPI | 1457707051 |
---|---|
Provider Name | Thomas James Lee |
First Address | Los Angeles, CA 91101 |
Second Address | Los Angeles, CA 91101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2016 |
Last Update Date | 25/01/2022 |