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NPI Code Detail

MEDICARE: KELVIN S LEE

MEDICARE:   KELVIN S LEE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1124625371
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELVIN S LEE
Provider Business Mailing Address
First Line : PO BOX 846915
Second Line :
City : LOS ANGELES
State : CA
Zip : 90084-6915
Country : US
Telephone Number : 310-246-1050
Fax Number :
Provider Business Practice Location Address
First Line : 1335 N LA BREA AVE STE 3
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-7565
Country : US
Telephone Number : 310-246-1050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2020
Last Update Date : 10/01/2020

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Directions to “ KELVIN S LEE ” Practice Location

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