Healthcare Provider Details

I. General information

NPI: 1578150231
Provider Name (Legal Business Name): DR. LEE PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S BEVERLY DR STE 420
LOS ANGELES CA
90035-1191
US

IV. Provider business mailing address

17725 CRENSHAW BLVD STE 206-1009
TORRANCE CA
90504-4138
US

V. Phone/Fax

Practice location:
  • Phone: 415-225-2333
  • Fax:
Mailing address:
  • Phone: 415-225-2333
  • Fax: 562-352-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN ANDREW LEE
Title or Position: CLINICAL ELECTROMYOGRAPHER
Credential: PT, DPT, ECS, OCS
Phone: 415-225-2333