Provider Demographics
NPI:1770229700
Name:LEE, WUNGHEE CHRISTINA (DPT)
Entity Type:Individual
Prefix:
First Name:WUNGHEE CHRISTINA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21015 PATHFINDER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4002
Mailing Address - Country:US
Mailing Address - Phone:909-861-3511
Mailing Address - Fax:909-860-7900
Practice Address - Street 1:21015 PATHFINDER RD STE 100
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4002
Practice Address - Country:US
Practice Address - Phone:909-861-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3020022251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic