Provider Demographics
NPI:1972762805
Name:LEE, ANDREW B (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:LEE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:113 WATERWORKS WAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3167
Mailing Address - Country:US
Mailing Address - Phone:949-872-2878
Mailing Address - Fax:949-872-2887
Practice Address - Street 1:113 WATERWORKS WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3167
Practice Address - Country:US
Practice Address - Phone:949-872-2878
Practice Address - Fax:949-872-2887
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00049419208000000X
CAA97744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics