Provider Demographics
NPI:1003838012
Name:LEE, PAUL CHOONG HWAN (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CHOONG HWAN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9894 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1643
Mailing Address - Country:US
Mailing Address - Phone:714-539-3232
Mailing Address - Fax:714-539-3555
Practice Address - Street 1:9894 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844
Practice Address - Country:US
Practice Address - Phone:714-539-3232
Practice Address - Fax:714-539-3555
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75260207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A752600Medicaid
H42977Medicare UPIN
CAA75260Medicare ID - Type Unspecified