Healthcare Provider Details

I. General information

NPI: 1063974764
Provider Name (Legal Business Name): JOSHUA LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W LA VETA AVE STE 360
ORANGE CA
92868-4303
US

IV. Provider business mailing address

1010 W LA VETA AVE STE 360
ORANGE CA
92868-4303
US

V. Phone/Fax

Practice location:
  • Phone: 714-245-0492
  • Fax: 714-245-0494
Mailing address:
  • Phone: 714-245-0492
  • Fax: 714-245-0494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA179284
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: