Healthcare Provider Details

I. General information

NPI: 1205501913
Provider Name (Legal Business Name): CHARLES CHULJOO RHEE M.S. T, M. ED, DBH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CITY BLVD W FL 17
ORANGE CA
92868-5905
US

IV. Provider business mailing address

633 W 5TH ST FL 26
LOS ANGELES CA
90071-2053
US

V. Phone/Fax

Practice location:
  • Phone: 213-700-5613
  • Fax:
Mailing address:
  • Phone: 213-700-5613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: