Healthcare Provider Details

I. General information

NPI: 1710911060
Provider Name (Legal Business Name): CHULL HI LEE, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S ATLANTIC BLVD
MONTEREY PARK CA
91754-4716
US

IV. Provider business mailing address

PO BOX 1430
MONROVIA CA
91017-1430
US

V. Phone/Fax

Practice location:
  • Phone: 626-570-9000
  • Fax:
Mailing address:
  • Phone: 626-256-6010
  • Fax: 626-256-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA31997
License Number StateCA

VIII. Authorized Official

Name: CHULL HI LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 626-570-9000