Provider Demographics
NPI:1518377852
Name:LEE, KRISTINA G (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:G
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 ROSECRANS AVENUE
Mailing Address - Street 2:DEPARTMENT OF HEMATOLOGY/ONCOLOGY, FIRST FLOOR
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706
Mailing Address - Country:US
Mailing Address - Phone:561-461-4611
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:DEPARTMENT OF MEDICINE 2B-182
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1437
Practice Address - Country:US
Practice Address - Phone:818-364-3205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program