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General NPI Number Information
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NPI Number | 1730197062
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Entity Type | Individual
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Provider Name | JAWCHYI LEE MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 13428 MAXELLA AVENUE #759
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6090
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Country | US
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Telephone | 310-529-7734
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Fax |
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Provider Business Mailing Address
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Address Line | 16835 ALGONQUIN ST # 125
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-3810
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Country | US
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Telephone | 310-529-7734
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01097875A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A70318
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 76929
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License Number State | AZ
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