Healthcare Provider Details

I. General information

NPI: 1013476126
Provider Name (Legal Business Name): PATRICK LEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16405 SAND CANYON AVE STE 280
IRVINE CA
92618-3792
US

IV. Provider business mailing address

2995 RED HILL AVE STE 100
COSTA MESA CA
92626-5984
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5793
  • Fax: 949-764-5792
Mailing address:
  • Phone: 949-764-5793
  • Fax: 949-764-5792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberA178327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: