Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | C54193 | CA |
NPI | 1134109200 |
---|---|
Provider Name | Dr. Dong Hyun Lee |
First Address | Los Angeles, CA 90006-2699 |
Second Address | Los Angeles, CA 90006-2699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 03/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1772949 | CIGNA (01) | |
7808895 | AETNA (01) | |
8168943 | UNITED HEALTHCARE / MAMSI (01) | |
P00430210 | RAILROAD MEDICARE (01) | |
W399 0010 | BCBS FEDERAL (01) |