MEDICARE: STEPHEN 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
1	174400000X	Specialist	A21288	CA
2	207ZH0000X	Hematology (Pathology) Physician	A21288	CA
3	207ZI0100X	Immunopathology Physician	A21288	CA
4	207ZP0101X	Anatomic Pathology Physician	A21288	CA
5	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A21288	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932105913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN LEE MD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD
Second Line	:	SUITE 400
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10833 LE CONTE AVE STE AL-135
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-3075
Country	:	US
Telephone Number	:	310-825-2071
Fax Number	:	310-794-4161

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	11/21/2019

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Directions to “ STEPHEN LEE MD” Practice Location

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