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Individual
DR. JIMMY LEE
Active
Individual
DR. JIMMY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4470
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4821080001
NORIDIAN DME SUPP ID#
CA
01
—
P00299462
PALMETTO GBA
CA
Enumeration date
06/30/2006
Last updated
02/27/2020
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