Basic Information
| Provider Information | |||||||||
| NPI: | 1619165040 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEE BURNETT DO A PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26161 MARGUERITE PKWY | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926923203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495828584 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26922 OSO PKWY | ||||||||
| Address2: | SUITE 380 | ||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926915800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495825430 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2007 | ||||||||
| LastUpdateDate: | 10/25/2007 | ||||||||
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| AuthorizedOfficialLastName: | SMITH-ARDREY | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 9494210709 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A7269 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.