Individual
JAY KYUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12980 FREDERICK ST, STE A, MORENO VALLEY, CA 92553-5263
(951) 924-0108
(951) 924-4776
Mailing address
12980 FREDERICK ST, STE A, MORENO VALLEY, CA 92553-5263
(951) 924-0108
(951) 924-4776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A85767
CA
Other
Enumeration date
06/27/2005
Last updated
01/06/2012
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