MEDICARE: DR. PAUL CHEN LEE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	A110986	CA
2	208VP0014X	Interventional Pain Medicine Physician	A110986	CA

General Provider Information

NPI Number	:	1003078981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL CHEN LEE M.D.

Provider Business Mailing Address
First Line	:	1440 N HARBOR BLVD STE 120
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92835-4114
Country	:	US
Telephone Number	:	855-906-7246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 N HARBOR BLVD STE 100
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92835-4114
Country	:	US
Telephone Number	:	855-906-7246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	10/07/2020

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