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Individual

EDWARD WOLFGANG LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
757 WESTWOOD PLZ STE 2125B, LOS ANGELES, CA 90095-8358
(310) 267-8751
(310) 206-3631
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A97746
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A97746
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A977460
CA
Enumeration date
10/17/2008
Last updated
12/16/2019
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