Provider Demographics
NPI:1538723382
Name:DONG HYUN LEE, MD, INC.
Entity type:Organization
Organization Name:DONG HYUN LEE, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONG
Authorized Official - Middle Name:HYUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-504-6404
Mailing Address - Street 1:78 SHADYWOOD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-7203
Mailing Address - Country:US
Mailing Address - Phone:714-504-6404
Mailing Address - Fax:
Practice Address - Street 1:2727 W OLYMPIC BLVD STE 309
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2699
Practice Address - Country:US
Practice Address - Phone:213-674-7758
Practice Address - Fax:213-674-7857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty