Provider Demographics
NPI:1881838662
Name:LEE, ONECHANG WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ONECHANG
Middle Name:WILLIAM
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ONE
Other - Middle Name:CHANG
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11190 WARNER AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4019
Mailing Address - Country:US
Mailing Address - Phone:714-433-2000
Mailing Address - Fax:
Practice Address - Street 1:11190 WARNER AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4019
Practice Address - Country:US
Practice Address - Phone:714-433-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-055125207T00000X
CAA143259207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery