Provider Demographics
NPI:1205826633
Name:LEE, JANET H (DO)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:H
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HYUN
Other - Middle Name:BONG
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:25550 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6825
Mailing Address - Country:US
Mailing Address - Phone:310-540-1712
Mailing Address - Fax:310-382-2118
Practice Address - Street 1:25550 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 116
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6825
Practice Address - Country:US
Practice Address - Phone:310-540-1712
Practice Address - Fax:310-382-2118
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I23877Medicare UPIN