Individual ProviderDavid LeeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address300 Stein Plaza Suite 420, Los Angeles, CA 90095-1063(310) 825-5111PECOS EnrollmentBased on the most recent information from CMS, provider David Lee is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1538775093Provider TypeIndividualFull NameLee, DavidGenderMaleSole ProprietorYesEnumeration Date9/21/2020Last Updated3/15/2022Contact InformationPractice LocationPractice Address300 Stein Plaza Suite 420, Los Angeles, CA 90095-1063Phone(310) 825-5111FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95015445California