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General NPI Number Information
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NPI Number | 1982795472
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Entity Type | Organization
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Legal Business Name | MARTIN H. LEE, M.D., INC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD STE 780
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City | LOS ANGELES
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State | CA
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Zip | 90017-4881
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Country | US
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Telephone | 213-480-0711
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Fax | 213-480-0715
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Provider Business Mailing Address
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Address Line | 3188 W OLYMPIC BLVD SUITE 103
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City | LOS ANGELES
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State | CA
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Zip | 90006-2421
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Country | US
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Telephone | 213-480-0711
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Fax | 213-480-0715
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARTIN HYUNGIL LEE
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Credential | M.D,
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Telephone | 213-480-0711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G53608
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License Number State | CA
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