Individual
DEREK LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5400 MOUNTAIN VISTA ST, APT 1421, LAS VEGAS, NV 89120-2161
(510) 754-9611
Mailing address
5400 MOUNTAIN VISTA ST, APT 1421, LAS VEGAS, NV 89120-2161
(510) 754-9611
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001994561
—
NV
Enumeration date
07/29/2015
Last updated
07/29/2015
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