Provider Demographics
NPI:1104927615
Name:LEE, JOSELYN CARMEL (MD)
Entity type:Individual
Prefix:
First Name:JOSELYN
Middle Name:CARMEL
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 24854
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-0854
Mailing Address - Country:US
Mailing Address - Phone:310-479-3147
Mailing Address - Fax:310-479-3147
Practice Address - Street 1:3740 ATLANTIC AVE STE 100
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3440
Practice Address - Country:US
Practice Address - Phone:310-869-8590
Practice Address - Fax:310-479-3147
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG0718562080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology