Doctor Name: | DR. SANFORD K LEE |
NPI Number: | 1194930636 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY10353 |
Business Practice Address: | 405 Via Corta Palos Verdes Estates, CA - 902741323 |
Business Phone Number: | 3103773070 |
Business Fax Number: | |
Mailing Address: | 716 Yarmouth Rd Ste 203, PALOS VERDES ESTATES |
State: | CA |
Postal Code: | 902742668 |
Phone Number: | 3103773070 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 01/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY10353 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |