Individual
DR. BENNETT LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2755 ALAMO ST, SUITE 101, SIMI VALLEY, CA 93065-1311
(805) 522-6577
(805) 522-7030
Mailing address
8510 BALBOA BLVD, SUITE 150, NORTHRIDGE, CA 91325-3583
(818) 357-5048
(818) 654-3417
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G64625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G646250
—
CA
Enumeration date
06/14/2006
Last updated
03/07/2023
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