Individual
JASON HESUNG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39700 BOB HOPE DR, SUITE 202, RANCHO MIRAGE, CA 92270-3267
(760) 341-2360
(760) 346-5940
Mailing address
39700 BOB HOPE DR, SUITE 202, RANCHO MIRAGE, CA 92270-3267
(760) 341-2360
(760) 346-5940
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
A108113
CA
208VP0014X
Interventional Pain Medicine Physician
25MA08008400
NJ
208VP0014X
Interventional Pain Medicine Physician
MD425992
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091511
—
NJ
05
—
1014610230002
—
NJ
05
—
101461023001
—
PA
01
—
1699298
AETNA
NJ
01
—
221971
US FAMILY HEALTH PLAN
NJ
01
—
2692016000
KEYSTONE MEDICARE 65
PA
01
—
330808867
BLUE CROSS
CA
01
—
54-2177172
PROCURA
NJ
01
—
6694216
CIGNA
NJ
01
—
A108113
CA LICENSE
CA
01
—
P00756965
MC RAIL ROAD
CA
01
—
X003305501
AMERICHOICE
PA
Enumeration date
06/14/2006
Last updated
12/15/2021
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