MEDICARE: WONHEE LEE

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	363LF0000X	Family Nurse Practitioner	95009420	CA

General Provider Information

NPI Number	:	1407338585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WONHEE LEE

Provider Business Mailing Address
First Line	:	12665 GARDEN GROVE BLVD STE 503
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1919
Country	:	US
Telephone Number	:	714-530-3740
Fax Number	:	714-530-0582

Provider Business Practice Location Address
First Line	:	12665 GARDEN GROVE BLVD STE 503
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1919
Country	:	US
Telephone Number	:	714-530-3740
Fax Number	:	714-530-0582

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

Provider Enumeration Date	:	09/05/2018
Last Update Date	:	02/09/2026

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Directions to “ WONHEE LEE ” Practice Location

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