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General NPI Number Information
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NPI Number | 1386370419
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Entity Type | Individual
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Provider Name | JEE EUN LEE
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Gender | Female
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Dates
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Enumeration Date | 07/30/2022
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 5832 BEACH BLVD UNIT 209
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City | BUENA PARK
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State | CA
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Zip | 90621-5501
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Country | US
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Telephone | 714-676-5541
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Fax | 714-676-5542
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Provider Business Mailing Address
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Address Line | 3136 OAKCREST DR
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City | CHINO HILLS
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State | CA
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Zip | 91709-2465
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Country | US
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Telephone | 626-465-8270
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95021150
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License Number State | CA
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