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General NPI Number Information
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NPI Number | 1558287300
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Entity Type | Individual
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Provider Name | YOUNGHOON LEE PTA
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Gender | Male
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 1400 S GRAND AVE STE 703
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City | LOS ANGELES
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State | CA
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Zip | 90015-3068
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Country | US
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Telephone | 323-408-8532
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Fax |
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Provider Business Mailing Address
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Address Line | 11260 KEY WEST AVE UNIT 3
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City | PORTER RANCH
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State | CA
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Zip | 91326-1602
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Country | US
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Telephone | 818-263-1973
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 52597
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License Number State | CA
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