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NPI Code Detail

MEDICARE: DR. JUDY JOOYUN LEE M.D.

MEDICARE: DR. JUDY JOOYUN LEE M.D.
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
1208000000XPediatrics PhysicianA75018CA

General Provider Information

NPI Number : 1134198922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDY JOOYUN LEE M.D.
Provider Business Mailing Address
First Line : 1300 N. VERMONT AVE
Second Line : SUITE 1002
City : LOS ANGELES
State : CA
Zip : 90028-1830
Country : US
Telephone Number : 323-953-7170
Fax Number :
Provider Business Practice Location Address
First Line : 4618 FOUNTAIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-1977
Country : US
Telephone Number : 323-953-7170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 12/22/2011

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