MEDICARE: CHING G 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
1	207R00000X	Internal Medicine Physician	G61762	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

General Provider Information

NPI Number	:	1821105321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHING G LEE MD

Provider Business Mailing Address
First Line	:	408 S. BEACH BLVD.
Second Line	:	#203
City	:	ANAHEIM
State	:	CA
Zip	:	92804
Country	:	US
Telephone Number	:	714-527-9111
Fax Number	:	714-527-7426

Provider Business Practice Location Address
First Line	:	408 S. BEACH BLVD.
Second Line	:	#203
City	:	ANAHEIM
State	:	CA
Zip	:	92804-1877
Country	:	US
Telephone Number	:	714-527-9111
Fax Number	:	714-527-7426

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	06/29/2011

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Directions to “ CHING G LEE MD” Practice Location

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