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General NPI Number Information
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NPI Number | 1528117991
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Entity Type | Organization
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Legal Business Name | CHANG J. LEE, MD, INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4811 FLORENCE AVE
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City | BELL
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State | CA
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Zip | 90201-4316
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Country | US
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Telephone | 323-562-3180
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Fax | 323-562-4979
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Provider Business Mailing Address
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Address Line | 4811 FLORENCE AVE 3203 EAST FLORENCE AVENUE, HUNTINGTON PARK
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City | BELL
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State | CA
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Zip | 90201-4316
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Country | US
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Telephone | 323-562-3180
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Fax | 323-562-4979
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHANG J LEE
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Credential | MD.
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Telephone | 323-562-3180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A36129
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License Number State | CA
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