MR. Jesse Lee

NPI #1780248062 in Thousand Oaks, California

Provider Information

NPI Number: 1780248062
Entity Type: Individual
Name: MR. Jesse Lee
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Apr 23, 2019
Last Updated: Apr 23, 2019

Practice Location

Address: 2230 LYNN RD STE 103
City: Thousand Oaks
State: California
ZIP Code: 91360-1958
Phone: (805) 495-5113

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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