Individual
MRS. GRACE JIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1950 SUNNY CREST DR, SUITE 2600, FULLERTON, CA 92835-3638
(714) 446-5260
(714) 446-5265
Mailing address
1950 SUNNY CREST DR, SUITE 2600, FULLERTON, CA 92835-3638
(714) 446-5260
(714) 446-5265
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA16726
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G471930
—
CA
Enumeration date
04/14/2006
Last updated
06/21/2024
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