Provider Demographics
NPI:1043462955
Name:LEE, STEVEN K (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2249
Mailing Address - Country:US
Mailing Address - Phone:909-423-0357
Mailing Address - Fax:909-423-0510
Practice Address - Street 1:20657 GOLDEN SPRINGS DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789-3860
Practice Address - Country:US
Practice Address - Phone:909-595-0011
Practice Address - Fax:909-595-0212
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor