MEDICARE: DR. PAUL T LEE M.D.

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
1	207Q00000X	Family Medicine Physician	A64277	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326042680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL T LEE M.D.

Provider Business Mailing Address
First Line	:	191 S BUENA VISTA STREET
Second Line	:	SUITE 200-240
City	:	BURBANK
State	:	CA
Zip	:	91505-4554
Country	:	US
Telephone Number	:	818-557-2671
Fax Number	:	818-557-0761

Provider Business Practice Location Address
First Line	:	191 S BUENA VISTA ST
Second Line	:	SUITE 200
City	:	BURBANK
State	:	CA
Zip	:	91505-4554
Country	:	US
Telephone Number	:	818-557-2671
Fax Number	:	818-557-0761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	11/10/2015

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