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General NPI Number Information
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NPI Number | 1689752677
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Entity Type | Individual
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Provider Name | CHONG YOON LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 13270 ROSE ST
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City | CERRITOS
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State | CA
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Zip | 90703-8644
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Country | US
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Telephone | 562-322-8608
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Fax |
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Provider Business Mailing Address
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Address Line | 13270 ROSE ST
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City | CERRITOS
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State | CA
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Zip | 90703-8644
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Country | US
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Telephone | 562-322-8608
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 34986
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7579
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE 60303875
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License Number State | WA
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