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General NPI Number Information
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NPI Number | 1487151379
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Entity Type | Organization
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Legal Business Name | CHRISTINA MYUNG DDS, INC.
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 12009 GARFIELD AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-7822
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Country | US
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Telephone | 562-630-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 12009 GARFIELD AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-7822
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Country | US
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Telephone | 562-630-7777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTINA SAE HEE LEE
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Credential | DDS
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Telephone | 213-393-6201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 61900
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License Number State | CA
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