MEDICARE: BENJAMIN 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	2085R0202X	Diagnostic Radiology Physician	A95001	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
2	00A950010	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1538299334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN LEE M.D.

Provider Business Mailing Address
First Line	:	DEPT LA 21650
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91185-1650
Country	:	US
Telephone Number	:	866-752-2080
Fax Number	:

Provider Business Practice Location Address
First Line	:	24451 HEALTH CENTER DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3689
Country	:	US
Telephone Number	:	949-452-3573
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	03/12/2026

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