Doctor Name: | JAE HOON LEE |
NPI Number: | 1912105297 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | LL1795 |
Business Practice Address: | 5016 Chesebro Rd Ste 200 Agoura Hills, CA - 913012210 |
Business Phone Number: | 8185286164 |
Business Fax Number: | 8189911200 |
Mailing Address: | 5016 Chesebro Rd, Ste 200 AGOURA HILLS |
State: | CA |
Postal Code: | 913012210 |
Phone Number: | 8185286164 |
Fax Number: | 8189911200 |
NPI Enumeration Date: | 07/06/2007 |
NPI Last Update Date: | 07/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | LL1795 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NV |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |