Healthcare Provider Details

I. General information

NPI: 1427854231
Provider Name (Legal Business Name): SEONG HAK LEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 E TEMPLE ST
LOS ANGELES CA
90012-3328
US

IV. Provider business mailing address

53026 SWEET JULIET LN
LAKE ELSINORE CA
92532-1563
US

V. Phone/Fax

Practice location:
  • Phone: 213-253-2677
  • Fax:
Mailing address:
  • Phone: 213-618-2064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW125321
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: