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NPI Code Detail

MEDICARE: SHIMWOO LEE M.D.

MEDICARE: SHIMWOO 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
12085R0204XVascular & Interventional Radiology PhysicianA158159CA

General Provider Information

NPI Number : 1982135315
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIMWOO LEE M.D.
Provider Business Mailing Address
First Line : 4650 W SUNSET BLVD
Second Line : MAILSTOP #81
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4650 W SUNSET BLVD
Second Line : MAILSTOP #81
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number : 323-660-2450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2017
Last Update Date : 02/20/2026

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