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NPI Code Detail

MEDICARE: BRIAN KHO LEE PA

MEDICARE: BRIAN KHO LEE PA
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
1363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1205642634
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN KHO LEE PA
Provider Business Mailing Address
First Line : 222 MAZATLAN ST
Second Line :
City : HENDERSON
State : NV
Zip : 89074-5262
Country : US
Telephone Number : 626-698-8184
Fax Number :
Provider Business Practice Location Address
First Line : 10105 BANBURRY CROSS DR STE 445
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-6645
Country : US
Telephone Number : 702-475-4390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2024
Last Update Date : 12/10/2024

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Directions to “ BRIAN KHO LEE PA” Practice Location

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