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NPI Code Detail

MEDICARE: DR. RICHARD JOONKOO LEE M.D.

MEDICARE: DR. RICHARD JOONKOO 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
12084P0804XChild & Adolescent Psychiatry PhysicianA72701CA

General Provider Information

NPI Number : 1407968068
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD JOONKOO LEE M.D.
Provider Business Mailing Address
First Line : 3125 MYERS ST
Second Line : RCDMH CHILDREN'S TREATMENT SERVICES
City : RIVERSIDE
State : CA
Zip : 92503-5527
Country : US
Telephone Number : 951-358-4840
Fax Number : 951-358-4848
Provider Business Practice Location Address
First Line : 3125 MYERS ST
Second Line : RCDMH CHILDREN'S TREATMENT SERVICES
City : RIVERSIDE
State : CA
Zip : 92503-5527
Country : US
Telephone Number : 951-358-4840
Fax Number : 951-358-4848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/08/2014

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