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NPI Code Detail

MEDICARE: JOHN GUNN LEE MD

MEDICARE: JOHN GUNN LEE MD
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
1207RG0100XGastroenterology Physician000000G63678CA

General Provider Information

NPI Number : 1487734521
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GUNN LEE MD
Provider Business Mailing Address
First Line : PO BOX 54509
Second Line : UCI DEPARTMENT OF MEDICINE
City : LOS ANGELES
State : CA
Zip : 90054-0509
Country : US
Telephone Number : 714-456-6369
Fax Number :
Provider Business Practice Location Address
First Line : 101 THE CITY DRIVE SOUTH
Second Line : UCI MEDICAL CENTER
City : ORANGE
State : CA
Zip : 92868-0509
Country : US
Telephone Number : 714-456-8978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 03/26/2014

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