Provider Demographics
NPI:1912297284
Name:KATZMAN, LEE RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:RICHARD
Last Name:KATZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1450 SAN PABLO ST FL 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4500
Mailing Address - Country:US
Mailing Address - Phone:323-442-6425
Mailing Address - Fax:323-442-6412
Practice Address - Street 1:7877 PARKWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2000
Practice Address - Country:US
Practice Address - Phone:619-460-3711
Practice Address - Fax:619-460-2184
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.059238207R00000X
MDP28486207W00000X
CAA135673207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine