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General NPI Number Information
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NPI Number | 1316111032
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Entity Type | Individual
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Provider Name | TAE HO LEE DPT
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Gender | Male
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 546 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5304
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Country | US
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Telephone | 714-257-5551
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Fax | 562-320-5167
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Provider Business Mailing Address
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Address Line | 546 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5304
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Country | US
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Telephone | 714-257-5551
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | TX60005621
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34285
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License Number State | CA
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