Provider Demographics
NPI:1922030204
Name:LEE, RICHARD HWAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HWAN
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 1:50 ALESSANDRO PL STE 210
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-4005
Mailing Address - Country:US
Mailing Address - Phone:626-514-0060
Mailing Address - Fax:626-514-0062
Practice Address - Street 1:50 ALESSANDRO PL STE 210
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-4005
Practice Address - Country:US
Practice Address - Phone:626-514-0060
Practice Address - Fax:626-514-0062
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73448207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A734480Medicaid
CAW18762Medicare PIN