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General NPI Number Information
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NPI Number | 1730683996
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Entity Type | Individual
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Provider Name | KI BUOM LEE MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 401 N BUFFALO DR STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89145-0397
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Country | US
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Telephone | 702-240-6482
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Fax |
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Provider Business Mailing Address
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Address Line | 801 S RANCHO DR STE E6
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City | LAS VEGAS
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State | NV
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Zip | 89106-3812
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Country | US
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Telephone | 702-240-6482
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 24393
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24393
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 24393
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License Number State | NV
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