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Individual

DR. LEE J PIATEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1500 PALM ST STE A, SAN LUIS OBISPO, CA 93401-2998
(805) 542-9678
Mailing address
3405 STUDIO DR, CAYUCOS, CA 93430-1937
(805) 995-1873

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
G28265
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G282650
CA
01
CH658Z
PTAN
CA
Enumeration date
08/29/2006
Last updated
05/05/2011
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