Individual
TAEJUN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
7077 HOPE CT, FONTANA, CA 92336-4457
(951) 903-8784
Mailing address
7077 HOPE CT, FONTANA, CA 92336-4457
(951) 903-8784
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA2872
CA
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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