Provider Demographics
NPI:1558458364
Name:LEE, JOSEPH Y (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:Y
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:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-0190
Mailing Address - Country:US
Mailing Address - Phone:714-228-1888
Mailing Address - Fax:714-676-8308
Practice Address - Street 1:5832 BEACH BLVD UNIT 109A
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-5500
Practice Address - Country:US
Practice Address - Phone:714-228-1888
Practice Address - Fax:714-676-8308
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60445207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A604450Medicaid
CAA60445Medicare ID - Type Unspecified
CA00A604450Medicaid