Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | C167412 | CA |
NPI | 1295050508 |
---|---|
Provider Name | Dr. Min Jung Lee |
First Address | Newport Beach, CA 92660-7688 |
Second Address | Newport Beach, CA 92660-7688 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 30/03/2021 |