MEDICARE: JOHN C LEE MD INC

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	261Q00000X	Clinic/Center	A37292	CA

General Provider Information

NPI Number	:	1487827929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN C LEE MD INC

Provider Business Mailing Address
First Line	:	638 W DUARTE RD
Second Line	:	SUITE 3
City	:	ARCADIA
State	:	CA
Zip	:	91007-7616
Country	:	US
Telephone Number	:	626-203-8049
Fax Number	:	626-282-7389

Provider Business Practice Location Address
First Line	:	638 W DUARTE RD
Second Line	:	SUITE 3
City	:	ARCADIA
State	:	CA
Zip	:	91007-7616
Country	:	US
Telephone Number	:	626-203-8049
Fax Number	:	626-348-8548

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN C LEE
Credential	:	MD
Telephone Number	:	626-203-8049

Provider Enumeration Date	:	04/04/2008
Last Update Date	:	02/03/2026

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