Provider Demographics
NPI:1316115579
Name:LEE, HARRISON H (MD, DMD, FACS)
Entity type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:MD, DMD, FACS
Other - Prefix:DR
Other - First Name:HEEYOUNG
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, DMD, FACS
Mailing Address - Street 1:120 S SPALDING DR STE 350
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1841
Mailing Address - Country:US
Mailing Address - Phone:310-777-2627
Mailing Address - Fax:310-777-2632
Practice Address - Street 1:120 S SPALDING DR STE 350
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1841
Practice Address - Country:US
Practice Address - Phone:310-777-2627
Practice Address - Fax:310-777-2632
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0836222082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck