Provider Demographics
NPI:1083790984
Name:YANG W. LEE,M.D. INC.
Entity Type:Organization
Organization Name:YANG W. LEE,M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YANG
Authorized Official - Middle Name:WEN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-423-1424
Mailing Address - Street 1:5981 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-3510
Mailing Address - Country:US
Mailing Address - Phone:562-423-1424
Mailing Address - Fax:562-422-7550
Practice Address - Street 1:5981 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-3510
Practice Address - Country:US
Practice Address - Phone:562-423-1424
Practice Address - Fax:562-422-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A303670Medicaid
CA00A303670Medicaid
A30367Medicare ID - Type Unspecified