Provider Demographics
NPI:1811737695
Name:GENE K LEE MEDICAL CORPORATION
Entity type:Organization
Organization Name:GENE K LEE MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:KYU
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:310-247-3777
Mailing Address - Street 1:9735 WILSHIRE BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2105
Mailing Address - Country:US
Mailing Address - Phone:310-247-3777
Mailing Address - Fax:
Practice Address - Street 1:9735 WILSHIRE BLVD STE 308
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2105
Practice Address - Country:US
Practice Address - Phone:310-247-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty