Provider Demographics
NPI:1720056781
Name:LEE, FRANCIS SANGWON (MD)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:SANGWON
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12555 GARDEN GROVE BLVD
Mailing Address - Street 2:#303
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843
Mailing Address - Country:US
Mailing Address - Phone:714-537-7766
Mailing Address - Fax:714-537-7361
Practice Address - Street 1:12555 GARDEN GROVE BLVD
Practice Address - Street 2:#303
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843
Practice Address - Country:US
Practice Address - Phone:714-537-7766
Practice Address - Fax:714-537-7361
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2011-10-10
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Provider Licenses
StateLicense IDTaxonomies
CAA64245208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A642450Medicaid
CA00A642450Medicaid
F60992Medicare UPIN