Provider Demographics
NPI:1245833623
Name:LEE, AARON IHN (PA-C)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:IHN
Last Name:LEE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 ROSEMARIE CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2858
Mailing Address - Country:US
Mailing Address - Phone:714-614-6164
Mailing Address - Fax:
Practice Address - Street 1:9485 ROSEMARIE CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2858
Practice Address - Country:US
Practice Address - Phone:714-614-6164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA59522363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA98648636COtherLA CARE HEALTH PLAN