Provider Demographics
NPI:1447586920
Name:CHING G. LEE M.D. INC
Entity type:Organization
Organization Name:CHING G. LEE M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHING
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-527-9111
Mailing Address - Street 1:408 S. BEACH BLVD.
Mailing Address - Street 2:#203
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804
Mailing Address - Country:US
Mailing Address - Phone:714-527-9111
Mailing Address - Fax:714-527-7426
Practice Address - Street 1:408 S. BEACH BLVD
Practice Address - Street 2:#203
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-1877
Practice Address - Country:US
Practice Address - Phone:714-527-9111
Practice Address - Fax:714-527-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61762207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty