MEDICARE: MRS. JULIANA YUN HWA 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	55930	CA

General Provider Information

NPI Number	:	1699946384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIANA YUN HWA LEE DDS

Provider Business Mailing Address
First Line	:	1223 BEGOVICH ST
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-5052
Country	:	US
Telephone Number	:	786-651-8381
Fax Number	:

Provider Business Practice Location Address
First Line	:	1223 BEGOVICH ST
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-5052
Country	:	US
Telephone Number	:	786-651-8381
Fax Number	:

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

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	11/24/2015

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