Healthcare Provider Details

I. General information

NPI: 1134290042
Provider Name (Legal Business Name): SHERRI LEE MOKUAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERRI JIA-LIANG LEE MD

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23781 MAQUINA
MISSION VIEJO CA
92691-2716
US

IV. Provider business mailing address

393 E WALNUT ST 3RD FLOOR PHR SYSTEMS
PASADENA CA
91188-0001
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-2800
  • Fax:
Mailing address:
  • Phone: 626-405-2681
  • Fax: 626-405-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA82295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: