Healthcare Provider Details

I. General information

NPI: 1124959911
Provider Name (Legal Business Name): JU-IN LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9353 VALLEY BLVD STE C
ROSEMEAD CA
91770-1923
US

IV. Provider business mailing address

291 N MADISON AVE APT 257
PASADENA CA
91101-4460
US

V. Phone/Fax

Practice location:
  • Phone: 626-287-2988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: