Provider Demographics
NPI:1659179281
Name:LEE, CLAIRE (DPT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:LEE
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 ADMIRALTY WAY STE 420
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6617
Mailing Address - Country:US
Mailing Address - Phone:424-526-5151
Mailing Address - Fax:
Practice Address - Street 1:4640 ADMIRALTY WAY
Practice Address - Street 2:UNIT 420
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6617
Practice Address - Country:US
Practice Address - Phone:424-526-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist