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General NPI Number Information
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NPI Number | 1033072426
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Entity Type | Individual
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Provider Name | JUNGHOE LEE
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Gender | Male
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 17300 N DYSART RD
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City | SURPRISE
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State | AZ
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Zip | 85378-4501
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Country | US
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Telephone | 623-233-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 N 159TH AVE UNIT 2061
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City | GOODYEAR
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State | AZ
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Zip | 85395-7189
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Country | US
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Telephone | 724-309-4027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 238758
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License Number State | AZ
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