Healthcare Provider Details

I. General information

NPI: 1962665349
Provider Name (Legal Business Name): SEUNG MIN LEE MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W CARSON ST STE D
TORRANCE CA
90502-2051
US

IV. Provider business mailing address

1001 W CARSON ST STE D
TORRANCE CA
90502-2051
US

V. Phone/Fax

Practice location:
  • Phone: 213-427-0667
  • Fax: 424-488-2177
Mailing address:
  • Phone: 213-427-0667
  • Fax: 424-288-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA68956
License Number StateCA

VIII. Authorized Official

Name: SEUNG M LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 213-427-0667