Healthcare Provider Details

I. General information

NPI: 1457214751
Provider Name (Legal Business Name): PETER MUPING LEE PT, DPT, PCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E MADISON AVE
EL CAJON CA
92019-1046
US

IV. Provider business mailing address

5530 OVERLAND AVE STE 150
SAN DIEGO CA
92123-1261
US

V. Phone/Fax

Practice location:
  • Phone: 619-588-3166
  • Fax:
Mailing address:
  • Phone: 619-528-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0018500
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: