Provider Demographics
NPI:1033316682
Name:LEE, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1955 SUNNYCREST DR.
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3653
Mailing Address - Country:US
Mailing Address - Phone:714-441-0133
Mailing Address - Fax:714-441-1082
Practice Address - Street 1:1955 SUNNYCREST DR.
Practice Address - Street 2:SUITE 108
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3653
Practice Address - Country:US
Practice Address - Phone:714-441-0133
Practice Address - Fax:714-441-1082
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG73421207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG73421BMedicare PIN
CAG73421Medicare PIN
CAG47905Medicare UPIN