Individual
JAE HOON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 N MAIN ST STE 120, SANTA ANA, CA 92701-4623
(714) 352-5800
(714) 352-5801
Mailing address
5016 CHESEBRO RD, STE 200, AGOURA HILLS, CA 91301-2210
(818) 528-6164
(818) 991-1200
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
A109172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A109172
LICENSE
CA
01
—
LL1795
NV MEDICAL LIC
NV
Enumeration date
07/06/2007
Last updated
08/19/2019
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