Individual
KOK W LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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