Provider Demographics
NPI:1447587431
Name:LEE, CLEMENT KIN-MAN (ND)
Entity Type:Individual
Prefix:DR
First Name:CLEMENT
Middle Name:KIN-MAN
Last Name:LEE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S LAKE AVE STE 298
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4868
Mailing Address - Country:US
Mailing Address - Phone:626-788-0023
Mailing Address - Fax:626-788-0013
Practice Address - Street 1:202 S LAKE AVE STE 298
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4868
Practice Address - Country:US
Practice Address - Phone:626-788-0023
Practice Address - Fax:626-788-0013
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-385175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAND-385OtherNATURPATHIC MEDICAL LICENSE NUMBER