MEDICARE: DR. BEOM MO LEE DDS

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	B46284	CA

General Provider Information

NPI Number	:	1235122243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEOM MO LEE DDS

Provider Business Mailing Address
First Line	:	966 S WESTERN AVE
Second Line	:	#207
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-1013
Country	:	US
Telephone Number	:	323-734-3710
Fax Number	:	323-734-2117

Provider Business Practice Location Address
First Line	:	966 S WESTERN AVE
Second Line	:	#207
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-1013
Country	:	US
Telephone Number	:	323-734-3710
Fax Number	:	323-734-2117

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1427031103 — L A MEDICAL SUPPLY INC
Practice Location Address:

966 S WESTERN AVE , 104
LOS ANGELES, CA
90006-1013

Practice Phone: 323-734-4800
Practice Fax: 373-734-0941

1043238769 — MOSES HYUN, M.D INC.
Practice Location Address:

966 S WESTERN AVE , STE 204
LOS ANGELES, CA
90006-1013

Practice Phone: 323-735-1300
Practice Fax: 323-735-6734

1164434676 — DR. EDWARD S RHEE DPM
Practice Location Address:

966 S WESTERN AVE , SUITE 205
LOS ANGELES, CA
90006-1013

Practice Phone: 323-733-1500
Practice Fax: 323-733-1724

1831395367 — BEOM MO LEE DENTAL CORP
Practice Location Address:

966 S WESTERN AVE , 207
LOS ANGELES, CA
90006-1013

Practice Phone: 323-734-2117
Practice Fax:

1427364918 — JONG CHANG LAC, OMD, PHD
Practice Location Address:

966 S WESTERN AVE , SUITE #206
LOS ANGELES, CA
90006-1013

Practice Phone: 323-735-1905
Practice Fax: 323-735-1905

1639451800 — JAE YONG YOO, M.D., INC
Practice Location Address:

966 S WESTERN AVE , SUITE 208
LOS ANGELES, CA
90006-1013

Practice Phone: 323-731-2001
Practice Fax: 323-731-1482

Directions to “ DR. BEOM MO LEE DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.