Individual
DR. CHANG SUP LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S VIRGIL AVE STE 103, LOS ANGELES, CA 90020-1425
(404) 783-3508
(213) 297-7978
Mailing address
520 S VIRGIL AVE STE 103, LOS ANGELES, CA 90020-1425
(213) 224-2020
(213) 444-4426
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A172874
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
A172874
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2017
Last updated
04/30/2026
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