Healthcare Provider Details

I. General information

NPI: 1225065659
Provider Name (Legal Business Name): JAMES J LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date: 04/30/2025
Reactivation Date: 05/20/2025

III. Provider practice location address

11550 INDIAN HILLS RD STE 261
MISSION HILLS CA
91345-1244
US

IV. Provider business mailing address

11550 INDIAN HILLS RD STE 261
MISSION HILLS CA
91345-1244
US

V. Phone/Fax

Practice location:
  • Phone: 818-361-0917
  • Fax: 818-496-7571
Mailing address:
  • Phone: 818-361-0917
  • Fax: 818-496-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberA84130
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA84130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: