Individual
JASON HAO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 GATEWAY DR, RIVERSIDE, CA 92507-0908
(951) 621-3478
Mailing address
2799 GATEWAY DR, RIVERSIDE, CA 92507-0908
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
39122
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39122
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
Enumeration date
07/03/2024
Last updated
07/03/2024
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