Provider Demographics
NPI:1285833764
Name:LEE, YOUNG E (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:E
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 N PIEDRAS ST.
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79920-5001
Mailing Address - Country:US
Mailing Address - Phone:915-569-2180
Mailing Address - Fax:915-569-1919
Practice Address - Street 1:1955 CITRACADO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4113
Practice Address - Country:US
Practice Address - Phone:760-743-0546
Practice Address - Fax:760-743-8837
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130275207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA130275OtherCA STATE LICENSE
CAA130275OtherCA STATE LICENSE