Individual
KYUNG LAE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
6771 WARNER AVE UNIT 2035, HUNTINGTON BEACH, CA 92647-9443
(213) 595-2123
Mailing address
6771 WARNER AVE UNIT 2035, HUNTINGTON BEACH, CA 92647-9443
(213) 595-2123
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95008938
CA
Other
Enumeration date
09/05/2018
Last updated
05/10/2019
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