MEDICARE: ROBERT 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	106H00000X	Marriage & Family Therapist	153167	CA

General Provider Information

NPI Number	:	1801558416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LEE

Provider Business Mailing Address
First Line	:	3210 DE WITT DR STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1422
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3210 DE WITT DR STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1422
Country	:	US
Telephone Number	:	323-609-8863
Fax Number	:

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

Provider Enumeration Date	:	10/11/2021
Last Update Date	:	12/19/2025

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Directions to “ ROBERT LEE ” Practice Location

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