Individual
DR. IVAN JISOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 W BASTANCHURY RD STE 285, FULLERTON, CA 92835-3432
(714) 738-4620
Mailing address
301 W BASTANCHURY RD STE 285, FULLERTON, CA 92835-3432
(714) 738-4620
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35.147835
OH
207W00000X
Ophthalmology Physician
Primary
A200827
CA
Other
Enumeration date
03/19/2019
Last updated
12/02/2025
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