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General NPI Number Information
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NPI Number | 1679100739
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Entity Type | Individual
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Provider Name | KYUNG HYUN LEE DO
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Gender | Male
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3201 S MARYLAND PKWY STE 318
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City | LAS VEGAS
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State | NV
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Zip | 89109-2425
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Country | US
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Telephone | 702-707-6960
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Fax | 702-707-6956
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Provider Business Mailing Address
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Address Line | PO BOX 29650 DEPT # 880504
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City | PHOENIX
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State | AZ
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Zip | 85038-9650
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Country | US
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Telephone | 702-707-6960
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Fax | 702-707-6956
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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 | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | DO3980
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | DO3980
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License Number State | NV
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