Provider Demographics
NPI:1902226293
Name:T. Y. LEE
Entity Type:Organization
Organization Name:T. Y. LEE
Other - Org Name:HEALTH ATLAST BEVERLY HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:JOCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-403-9478
Mailing Address - Street 1:9478 W OLYMPIC BLVD
Mailing Address - Street 2:PENTHOUSE
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4246
Mailing Address - Country:US
Mailing Address - Phone:310-556-8071
Mailing Address - Fax:310-556-3880
Practice Address - Street 1:9478 W OLYMPIC BLVD
Practice Address - Street 2:PENTHOUSE
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4246
Practice Address - Country:US
Practice Address - Phone:310-556-8071
Practice Address - Fax:310-556-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11633208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty