Individual
GRACE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 S FAIR OAKS AVE STE 270&380, PASADENA, CA 91105-2613
(424) 314-0177
(424) 314-0180
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
(310) 423-4700
(310) 423-4711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
55812
CA
Other
Enumeration date
08/20/2018
Last updated
08/08/2023
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