Individual
CHANYOUNG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
265 16TH ST, RICHMOND, CA 94801-3214
(510) 233-6515
Mailing address
1800 JEFFERSON PARK AVE APT 904, CHARLOTTESVILLE, VA 22903-3539
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104375
CA
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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