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Individual

ELLEN KYUNGCHAE LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2221 LINCOLN BLVD STE 100, SANTA MONICA, CA 90405-1320
(310) 392-1111
(310) 392-1101
Mailing address
2221 LINCOLN BLVD STE 100, SANTA MONICA, CA 90405-1320
(310) 392-1111
(310) 392-1101

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
11/05/2019
Last updated
10/20/2025
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