Basic Information
| Provider Information | |||||||||
| NPI: | 1487943510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2898 LINDEN AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908061627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629882995 | ||||||||
| FaxNumber: | 5629890999 | ||||||||
| Practice Location | |||||||||
| Address1: | 2898 LINDEN AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908061627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625958671 | ||||||||
| FaxNumber: | 5624902015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2011 | ||||||||
| LastUpdateDate: | 12/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A116281 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0001X | 116281 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207RC0000X | 116281 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.