Provider Demographics
NPI:1992877427
Name:LEE, STEVEN K (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:300 S HOBART BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3635
Mailing Address - Country:US
Mailing Address - Phone:213-387-1417
Mailing Address - Fax:213-387-1256
Practice Address - Street 1:300 S HOBART BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3635
Practice Address - Country:US
Practice Address - Phone:213-387-1417
Practice Address - Fax:213-387-1256
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG53712207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G537120Medicaid
CA00G537120Medicaid
CAWG53712AMedicare ID - Type Unspecified