Doctor Name: | MS. KIA LEE |
NPI Number: | 1003956012 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP, MSN, BA |
License Number: | 16642 |
Business Practice Address: | 655 Euclid Ave Suite 305 National City, CA - 919502957 |
Business Phone Number: | 6198187205 |
Business Fax Number: | |
Mailing Address: | 4331 53rd St Apt 16, SAN DIEGO |
State: | CA |
Postal Code: | 921155268 |
Phone Number: | 6198187205 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 16642 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |