Individual
GAVIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7210 N MILBURN AVE STE 101, FRESNO, CA 93722-8449
(559) 224-5101
Mailing address
4773 HAZELNUT AVE, SEAL BEACH, CA 90740-3016
(562) 296-3015
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5623
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2018
Last updated
08/12/2020
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