Healthcare Provider Details

I. General information

NPI: 1790602639
Provider Name (Legal Business Name): SEUNG YUN LEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LEO LEE PHARM.D.

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2623 E SLAUSON AVE
HUNTINGTON PARK CA
90255-2926
US

IV. Provider business mailing address

12105 SUMMER LN
WHITTIER CA
90602-1078
US

V. Phone/Fax

Practice location:
  • Phone: 323-583-1931
  • Fax:
Mailing address:
  • Phone: 626-862-3667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number81685
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: