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General NPI Number Information
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NPI Number | 1609232727
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Entity Type | Individual
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Provider Name | CHRISTOPHER LEE
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Gender | Male
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 3930 4TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-3119
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Country | US
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Telephone | 619-200-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 16011 BUTTERFIELD RANCH RD UNIT 638
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City | CHINO HILLS
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State | CA
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Zip | 91709-7455
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Country | US
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Telephone | 408-836-6004
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT11040
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License Number State | CA
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