MEDICARE: YUNA LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207L00000X	Anesthesiology Physician	A129693	CA

General Provider Information

NPI Number	:	1538435433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUNA LEE

Provider Business Mailing Address
First Line	:	PO BOX 60790
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91116-6790
Country	:	US
Telephone Number	:	626-204-6747
Fax Number	:	626-396-0851

Provider Business Practice Location Address
First Line	:	1443 BARRY AVE APT 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2375
Country	:	US
Telephone Number	:	310-267-8655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2012
Last Update Date	:	12/06/2021

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Directions to “ YUNA LEE ” Practice Location

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