MEDICARE: DR. ROBERT LEE DO

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	2084P0800X	Psychiatry Physician	20A17421	CA

General Provider Information

NPI Number	:	1679839385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LEE DO

Provider Business Mailing Address
First Line	:	1431 W BOROS CT
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-2047
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23041 AVENIDA DE LA CARLOTA
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1511
Country	:	US
Telephone Number	:	424-265-0846
Fax Number	:

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

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	12/01/2021

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