Individual
DR. SAMUEL SHIN KWON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18400 US HIGHWAY 18, APPLE VALLEY, CA 92307-2306
(760) 242-3939
(760) 242-3232
Mailing address
18400 US HIGHWAY 18, APPLE VALLEY, CA 92307-2306
(760) 242-3939
(760) 242-3232
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
060213
GA
208800000X
Urology Physician
110101
MO
208800000X
Urology Physician
Primary
A49819
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
785000022
MEDICARE PART B
MO
Enumeration date
05/30/2006
Last updated
06/15/2012
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