Healthcare Provider Details

I. General information

NPI: 1699695098
Provider Name (Legal Business Name): EDWARD S LEE MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 W LA VETA AVE STE 520
ORANGE CA
92868-4227
US

IV. Provider business mailing address

1140 W LA VETA AVE STE 520
ORANGE CA
92868-4227
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-2000
  • Fax:
Mailing address:
  • Phone: 714-543-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD LEE
Title or Position: OWNER
Credential: MD
Phone: 714-543-2000