Provider Demographics
NPI:1609905173
Name:LEE, RAYMOND E (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:E
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 1:7333 RESIDENCIA
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-9057
Mailing Address - Country:US
Mailing Address - Phone:949-230-7377
Mailing Address - Fax:
Practice Address - Street 1:4 HUTTON CENTRE DR
Practice Address - Street 2:350
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-8706
Practice Address - Country:US
Practice Address - Phone:714-435-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94779207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery