Provider Demographics
NPI:1639799273
Name:LEE, DANNY JAJUNE
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:JAJUNE
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 LOMITA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2084
Mailing Address - Country:US
Mailing Address - Phone:310-534-6221
Mailing Address - Fax:
Practice Address - Street 1:1403 LOMITA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2084
Practice Address - Country:US
Practice Address - Phone:310-534-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program