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Individual

DR. MARY MIMI LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-3504
(098) 257-0849
Mailing address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
302352
NY
2086S0129X
Vascular Surgery Physician
Primary
19531
CA

Other

Enumeration date
03/02/2015
Last updated
06/20/2023
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