Provider Demographics
NPI:1568648608
Name:LEE, JOHN YOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:YOUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:421 E MERCED AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-5023
Mailing Address - Country:US
Mailing Address - Phone:626-918-1881
Mailing Address - Fax:626-214-9290
Practice Address - Street 1:421 E MERCED AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-5023
Practice Address - Country:US
Practice Address - Phone:626-918-1881
Practice Address - Fax:626-214-9290
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA001462208800000X
CAA112929208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology