Healthcare Provider Details

I. General information

NPI: 1992654081
Provider Name (Legal Business Name): HYE KYOUNG LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 ARTESIA BLVD
CERRITOS CA
90701-4065
US

IV. Provider business mailing address

11439 EXCELSIOR DR UNIT A
NORWALK CA
90650-5757
US

V. Phone/Fax

Practice location:
  • Phone: 562-402-7622
  • Fax:
Mailing address:
  • Phone: 714-232-9755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: