Individual
DR. JACKSON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 SAN PABLO ST, 2000, LOS ANGELES, CA 90033-5310
(323) 442-5860
Mailing address
1200 N STATE ST, LOS ANGELES, CA 90033-1029
(323) 226-2170
(323) 226-5760
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G62123
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
G62123
CA
Other
Enumeration date
01/24/2007
Last updated
03/02/2015
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