Provider Demographics
NPI:1982685327
Name:LEE, JOHN STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STANLEY
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9675 BRIGHTON WAY
Mailing Address - Street 2:STE 390
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5100
Mailing Address - Country:US
Mailing Address - Phone:310-274-6482
Mailing Address - Fax:310-274-1959
Practice Address - Street 1:9675 BRIGHTON WAY
Practice Address - Street 2:STE 390
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5100
Practice Address - Country:US
Practice Address - Phone:310-274-6482
Practice Address - Fax:310-274-1959
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA33764207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A27246Medicare UPIN
CAA33764Medicare ID - Type Unspecified