Individual
JACOB C LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1164 BISHOP ST STE 1611, HONOLULU, HI 96813-2816
(808) 261-7792
Mailing address
801 SOUTH ST APT 3313, HONOLULU, HI 96813-5937
(636) 368-5044
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
227280
HI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/11/2018
Last updated
07/09/2023
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