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Individual

KOK W LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
208 N GARFIELD AVE, MONTEREY PARK, CA 91754-1705
(626) 288-8029
(626) 288-7056
Mailing address
208 N GARFIELD AVE, MONTEREY PARK, CA 91754-1705
(626) 288-8029
(626) 288-7056

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C43200
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C432000
CA
01
W8705D
MEDICARE GROUP PTAN
CA
01
WC43200B
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
10/06/2006
Last updated
12/20/2007
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