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General NPI Number Information
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NPI Number | 1356531743
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Entity Type | Organization
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Legal Business Name | KEVIN T. LEE, M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | 5801 ROSEMEAD BLVD
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City | TEMPLE CITY
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State | CA
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Zip | 91780-1852
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Country | US
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Telephone | 626-292-1241
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Fax | 626-292-1746
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Provider Business Mailing Address
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Address Line | 5801 ROSEMEAD BLVD
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City | TEMPLE CITY
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State | CA
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Zip | 91780-1852
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Country | US
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Telephone | 626-292-1241
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Fax | 626-292-1746
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVIN T LEE
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Credential | M.D.
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Telephone | 626-292-1241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A99354
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License Number State | CA
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