Individual
JIN SONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
86-260 FARRINGTON HWY, WAIANAE, HI 96792-3128
(808) 697-3300
Mailing address
3014 W CHARLESTON BLVD STE 130, LAS VEGAS, NV 89102-0083
(702) 671-5127
(702) 671-6440
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2550
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2020
Last updated
06/09/2024
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