Provider Demographics
NPI:1326700790
Name:LEE, HYUN KYUNG (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HYUN KYUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 W GOLDLEAF CIR FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1658
Mailing Address - Country:US
Mailing Address - Phone:323-293-7171
Mailing Address - Fax:
Practice Address - Street 1:4900 BARRANCA PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8603
Practice Address - Country:US
Practice Address - Phone:949-791-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily