Provider Demographics
NPI:1235010240
Name:LEE, JUNG HYUN
Entity type:Individual
Prefix:
First Name:JUNG HYUN
Middle Name:
Last Name:LEE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:JUNG HYUN
Other - Middle Name:IRENE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3385 MICHELSON DR APT 213
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-3459
Mailing Address - Country:US
Mailing Address - Phone:909-999-1432
Mailing Address - Fax:
Practice Address - Street 1:3385 MICHELSON DR APT 213
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-3459
Practice Address - Country:US
Practice Address - Phone:909-999-1432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95334868163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse