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NPI Code Detail

MEDICARE: STEVE KIBUOM LEE MD

MEDICARE:   STEVE KIBUOM LEE  MD
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
1207RI0011XInterventional Cardiology Physician24393NV
2207RC0000XCardiovascular Disease Physician24393NV
3390200000XStudent in an Organized Health Care Education/Training Program
4207R00000XInternal Medicine Physician24393NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1390200000XOTHERSTUDENT HEALTH CARE

General Provider Information

NPI Number : 1730683996
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVE KIBUOM LEE MD
Provider Business Mailing Address
First Line : 801 S RANCHO DR STE E6
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-3812
Country : US
Telephone Number : 702-240-6482
Fax Number :
Provider Business Practice Location Address
First Line : 401 N BUFFALO DR STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-0397
Country : US
Telephone Number : 702-240-6482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 05/12/2026

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Directions to “ STEVE KIBUOM LEE MD” Practice Location

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