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General NPI Number Information
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NPI Number | 1861865545
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Entity Type | Individual
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Provider Name | DR. DANIEL KWANG-SOO LEE
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Gender | Male
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 1645 E 103RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90002-2923
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Country | US
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Telephone | 323-564-5787
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Fax |
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Provider Business Mailing Address
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Address Line | 20475 YORBA LINDA BLVD
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City | YORBA LINDA
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State | CA
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Zip | 92886-3043
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Country | US
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Telephone | 714-693-1055
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 68936
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License Number State | CA
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