Healthcare Provider Details

I. General information

NPI: 1083922777
Provider Name (Legal Business Name): LEE ORTHOPAEDIC INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 E PALMDALE BLVD SUITE 201
PALMDALE CA
93550-4745
US

IV. Provider business mailing address

1500 S CENTRAL AVE SUITE 206
GLENDALE CA
91204-2530
US

V. Phone/Fax

Practice location:
  • Phone: 661-456-3177
  • Fax: 661-266-1373
Mailing address:
  • Phone: 818-550-9910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberG86203
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberA67707
License Number StateCA

VIII. Authorized Official

Name: DR. CHRISTOPHE S LEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-550-9910