Provider Demographics
NPI:1578628731
Name:LEE, PHILLIP HOWARD ANDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:HOWARD ANDERSON
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2603
Mailing Address - Country:US
Mailing Address - Phone:626-405-7221
Mailing Address - Fax:626-405-7208
Practice Address - Street 1:401 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2603
Practice Address - Country:US
Practice Address - Phone:626-405-7221
Practice Address - Fax:626-405-7208
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84665207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology