Provider Demographics
NPI:1225065659
Name:LEE, JAMES J (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 INDIAN HILLS RD STE 261
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1244
Mailing Address - Country:US
Mailing Address - Phone:818-361-0917
Mailing Address - Fax:818-496-7571
Practice Address - Street 1:11550 INDIAN HILLS RD STE 261
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1244
Practice Address - Country:US
Practice Address - Phone:818-361-0917
Practice Address - Fax:818-496-7571
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2025-05-20
Deactivation Date:2025-04-30
Deactivation Code:
Reactivation Date:2025-05-20
Provider Licenses
StateLicense IDTaxonomies
CAA841302082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD32274Medicare UPIN