Provider Demographics
NPI:1255590527
Name:LEE, JULIANNE OHNMAR (MD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:OHNMAR
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:711 N ALVARADO ST STE 106
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-4016
Mailing Address - Country:US
Mailing Address - Phone:213-413-3324
Mailing Address - Fax:213-413-6017
Practice Address - Street 1:711 N ALVARADO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-4016
Practice Address - Country:US
Practice Address - Phone:213-413-3324
Practice Address - Fax:213-413-6017
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97817208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics