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General NPI Number Information
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NPI Number | 1316416134
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Entity Type | Organization
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Legal Business Name | EDWIN A LEE MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 1300 N VERMONT AVE STE 808
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City | LOS ANGELES
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State | CA
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Zip | 90027-6091
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Country | US
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Telephone | 323-694-4900
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Fax | 323-284-8930
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Provider Business Mailing Address
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Address Line | 1300 N VERMONT AVE STE 808
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City | LOS ANGELES
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State | CA
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Zip | 90027-6091
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Country | US
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Telephone | 323-694-4900
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Fax | 323-284-8930
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWIN A LEE
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Credential |
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Telephone | 323-694-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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