Provider Demographics
NPI:1871749382
Name:LEE, LINDA SOOJIN (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SOOJIN
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20635 VIA BELARMINO
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3129
Mailing Address - Country:US
Mailing Address - Phone:516-353-0365
Mailing Address - Fax:
Practice Address - Street 1:20635 VIA BELARMINO
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-3129
Practice Address - Country:US
Practice Address - Phone:516-353-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107543207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine