Provider Demographics
NPI:1114246568
Name:LEE, AARON J (DO)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:J
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 INDIANA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RIVERSDIE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-4557
Mailing Address - Country:US
Mailing Address - Phone:951-276-9012
Mailing Address - Fax:951-276-9163
Practice Address - Street 1:7111 INDIANA AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504
Practice Address - Country:US
Practice Address - Phone:951-276-9012
Practice Address - Fax:951-276-9163
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A15545208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program