Individual
JAEWON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
161 FASHION LN STE 209, TUSTIN, CA 92780-3331
(714) 922-0017
(714) 364-5415
Mailing address
1950 W CORPORATE WAY # 60175, ANAHEIM, CA 92801-5373
(714) 922-0017
(714) 364-5415
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95008747
CA
Other
Enumeration date
05/04/2018
Last updated
08/13/2026
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