Individual
AUSTIN TYLER LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(323) 298-3680
(323) 292-0053
Mailing address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(323) 298-3680
(323) 292-0053
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F6936637
DL NUMBER
CA
Enumeration date
02/04/2020
Last updated
03/27/2026
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