Provider Demographics
NPI:1437287315
Name:LEE, WILLIAM JAMES (MPAS)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JAMES
Last Name:LEE
Suffix:
Gender:M
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 ARTESIA BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3207
Mailing Address - Country:US
Mailing Address - Phone:424-276-4700
Mailing Address - Fax:424-903-1099
Practice Address - Street 1:40663 MURRIETA HOT SPRINGS RD STE C3
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9015
Practice Address - Country:US
Practice Address - Phone:951-677-5341
Practice Address - Fax:951-387-8004
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13497207N00000X
CAPA13497363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207N00000XAllopathic & Osteopathic PhysiciansDermatology