Individual
SELINA T LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
15725 E WHITTIER BLVD, WHITTIER, CA 90603-2347
(562) 947-8478
(562) 947-2238
Mailing address
P O BOX 1277, WHITTIER, CA 90609-1277
(562) 906-6470
(562) 946-9465
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA14034
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA14034
CA STATE LICENSE
CA
Enumeration date
09/20/2007
Last updated
09/20/2007
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