MEDICARE: PAUL LEE MSN, FNP-C

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	163W00000X	Registered Nurse	95192178	CA
2	363L00000X	Nurse Practitioner	95026899	CA

General Provider Information

NPI Number	:	1972384840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL LEE MSN, FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 51954
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92619-1954
Country	:	US
Telephone Number	:	646-584-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1245 WILSHIRE BLVD STE 406
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-4804
Country	:	US
Telephone Number	:	213-372-5245
Fax Number	:	213-372-5217

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

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	11/22/2023

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