Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A75260 | CA |
NPI | 1003838012 |
---|---|
Provider Name | Paul Choong Hwan Lee |
First Address | Garden Grove, CA 92844-1643 |
Second Address | Garden Grove, CA 92844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 05/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A752600 | (05) | CA |
H42977 | (02) |