Provider Demographics
NPI:1326254137
Name:LEE, TIMOTHY TIEN-MIN (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:TIEN-MIN
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 1:10737 LAUREL ST STE 230
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7659
Mailing Address - Country:US
Mailing Address - Phone:909-989-5556
Mailing Address - Fax:909-989-5558
Practice Address - Street 1:10737 LAUREL ST STE 230
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7659
Practice Address - Country:US
Practice Address - Phone:909-989-5556
Practice Address - Fax:909-989-5558
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1010502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry