Healthcare Provider Details

I. General information

NPI: 1629525332
Provider Name (Legal Business Name): BRIAN ANDREW LEE PT, DPT, ECS, OCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
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

18002 GRAMERCY PL
TORRANCE CA
90504-4325
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number291624
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number291624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: