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General NPI Number Information
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NPI Number | 1780040840
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Entity Type | Organization
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Legal Business Name | JOHN J LEE MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 35400 BOB HOPE DR STE 103&104
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1708
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Country | US
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Telephone | 760-875-2116
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Fax | 760-266-6184
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Provider Business Mailing Address
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Address Line | 35400 BOB HOPE DR STE 103
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1772
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Country | US
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Telephone | 760-875-2116
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Fax | 760-266-6184
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Authorized Official
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Title or Position | CREDENTIALLING MANAGER
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Name | MR. TAYYAB WASEEM
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Credential |
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Telephone | 760-565-3554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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