MEDICARE: KEVIN KA YUNG 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
1	208800000X	Urology Physician	142519	CA

General Provider Information

NPI Number	:	1457641870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN KA YUNG LEE

Provider Business Mailing Address
First Line	:	600 N GARFIELD AVE STE 308
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1169
Country	:	US
Telephone Number	:	626-288-0889
Fax Number	:	626-288-1129

Provider Business Practice Location Address
First Line	:	600 N GARFIELD AVE STE 308
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1169
Country	:	US
Telephone Number	:	626-288-0889
Fax Number	:	626-288-1129

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

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	02/23/2017

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Directions to “ KEVIN KA YUNG LEE ” Practice Location

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