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NPI Code Detail

MEDICARE: EUN RYANG LEE

MEDICARE: EUN RYANG 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
13747P1801XPersonal Care Attendant082456-C2-MHCNV

General Provider Information

NPI Number : 1821824061
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUN RYANG LEE
Provider Business Mailing Address
First Line : 10216 BIRCH BLUFF LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8829
Country : US
Telephone Number : 925-917-9357
Fax Number :
Provider Business Practice Location Address
First Line : 1401 ARVILLE ST STE G
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-0537
Country : US
Telephone Number : 702-738-0515
Fax Number : 702-527-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2024
Last Update Date : 09/29/2024

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Directions to “ EUN RYANG LEE ” Practice Location

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