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Individual

DR. CHARLES KYUNG CHUL LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1545 PINE ST., UNIT 101, SAN FRANCISCO, CA 94109-1078
(415) 933-8330
(415) 933-8292
Mailing address
1545 PINE ST., UNIT 101, SAN FRANCISCO, CA 94109-4682
(415) 933-8330
(415) 933-8292

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A82918
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A829180
BLUE SHIELD
CA
05
00A829180
CA
Enumeration date
11/09/2005
Last updated
08/24/2021
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