Provider Demographics
NPI:1912968975
Name:JAMES J LEE MD
Entity Type:Organization
Organization Name:JAMES J LEE MD
Other - Org Name:NORTHERN ORANGE COUNTY ENT MED CORP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-956-5440
Mailing Address - Street 1:1211 W LA PALMA AVE
Mailing Address - Street 2:STE 610
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801
Mailing Address - Country:US
Mailing Address - Phone:714-956-5440
Mailing Address - Fax:714-956-0581
Practice Address - Street 1:1211 W LA PALMA AVE
Practice Address - Street 2:STE 610
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801
Practice Address - Country:US
Practice Address - Phone:714-956-5440
Practice Address - Fax:714-956-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73421207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G47905Medicare UPIN
CAG73421Medicare ID - Type Unspecified