Provider Demographics
NPI:1235114836
Name:LEE, BRIAN F (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:F
Last Name:LEE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 TAYLOR BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2297
Mailing Address - Country:US
Mailing Address - Phone:925-692-1160
Mailing Address - Fax:925-692-5850
Practice Address - Street 1:399 TAYLOR BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2297
Practice Address - Country:US
Practice Address - Phone:925-692-1160
Practice Address - Fax:925-692-5850
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27856225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT278560Medicare ID - Type Unspecified