MEDICARE: ASHLEY SOYEONG LEE PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1437003324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY SOYEONG LEE PA-C

Provider Business Mailing Address
First Line	:	966 S WESTERN AVE STE 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-1014
Country	:	US
Telephone Number	:	213-267-2256
Fax Number	:	213-463-9131

Provider Business Practice Location Address
First Line	:	966 S WESTERN AVE STE 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-1014
Country	:	US
Telephone Number	:	213-267-2256
Fax Number	:	213-463-9131

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

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	04/23/2026

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Directions to “ ASHLEY SOYEONG LEE PA-C” Practice Location

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