Provider Demographics
NPI:1457387532
Name:LEE, BENJAMIN PIN HSUN (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:PIN HSUN
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 1:24040 CAMINO DEL AVION
Mailing Address - Street 2:SUITE A195
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-4005
Mailing Address - Country:US
Mailing Address - Phone:201-787-8190
Mailing Address - Fax:
Practice Address - Street 1:300 W HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3402
Practice Address - Country:US
Practice Address - Phone:626-574-3456
Practice Address - Fax:626-821-6927
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73276207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A732760Medicaid
CA00A732760Medicaid
CAH57754Medicare UPIN
CAWA73276DMedicare PIN