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General NPI Number Information
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NPI Number | 1770907826
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Entity Type | Individual
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Provider Name | RACHEL LEE D.D.S., M.S.
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Gender | Female
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 505 S BONNIE BRAE ST APT 501
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City | LOS ANGELES
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State | CA
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Zip | 90057-5232
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Country | US
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Telephone | 626-354-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 505 S BONNIE BRAE ST APT 501
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City | LOS ANGELES
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State | CA
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Zip | 90057-5232
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | LL-386-14
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 101250
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License Number State | CA
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