MEDICARE: DR. YUN S. LEE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	53238	CA

General Provider Information

NPI Number	:	1003818782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YUN S. LEE D.D.S.

Provider Business Mailing Address
First Line	:	3550 WILSHIRE BLVD
Second Line	:	835
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2401
Country	:	US
Telephone Number	:	213-251-0066
Fax Number	:	213-380-8228

Provider Business Practice Location Address
First Line	:	3550 WILSHIRE BLVD
Second Line	:	835
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2401
Country	:	US
Telephone Number	:	213-251-0066
Fax Number	:	213-380-8228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	08/27/2007

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