Provider Demographics
NPI:1407007594
Name:LEE, YONG H (DO)
Entity Type:Individual
Prefix:
First Name:YONG
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9535 GARDEN GROVE BLVD
Mailing Address - Street 2:104
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1550
Mailing Address - Country:US
Mailing Address - Phone:562-396-5126
Mailing Address - Fax:
Practice Address - Street 1:9535 GARDEN GROVE BLVD
Practice Address - Street 2:104
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1550
Practice Address - Country:US
Practice Address - Phone:562-396-5126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine