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General NPI Number Information
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NPI Number | 1881012656
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Entity Type | Organization
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Legal Business Name | KATHERINE BAO-SHIAN LEE, M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/30/2014
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Last Update Date | 03/30/2014
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Provider Practice Location Address
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Address Line | 24431 CALLE DE LA LOUISA SUITE 200
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7641
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Country | US
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Telephone | 949-266-0216
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Fax | 949-266-0216
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Provider Business Mailing Address
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Address Line | 57 TIMBERLAND
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City | ALISO VIEJO
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State | CA
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Zip | 92656-2108
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Country | US
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Telephone | 949-266-0216
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Fax | 949-266-0216
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHERINE LEE
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Credential | M.D.
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Telephone | 949-266-0216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A120778
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License Number State | CA
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