Healthcare Provider Details

I. General information

NPI: 1932234382
Provider Name (Legal Business Name): BECKY SIU-FUN LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

IV. Provider business mailing address

1100 ABBOT AVE
SAN GABRIEL CA
91776-2904
US

V. Phone/Fax

Practice location:
  • Phone: 213-744-3734
  • Fax:
Mailing address:
  • Phone: 626-570-0827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number307832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: