Healthcare Provider Details

I. General information

NPI: 1992877427
Provider Name (Legal Business Name): STEVEN K. LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S HOBART BLVD SUITE 301
LOS ANGELES CA
90020-3635
US

IV. Provider business mailing address

300 S HOBART BLVD SUITE 301
LOS ANGELES CA
90020-3635
US

V. Phone/Fax

Practice location:
  • Phone: 213-387-1417
  • Fax: 213-387-1256
Mailing address:
  • Phone: 213-387-1417
  • Fax: 213-387-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberG53712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: