| Jae Hoon Lee MD Inc | |
|
4221 Wilshire Blvd Ste 311 Los Angeles CA 90010-3537 | |
| (323) 917-5155 | |
| Not Available |
| Full Name | Jae Hoon Lee MD Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4221 Wilshire Blvd Ste 311, Los Angeles, California |
| Authorized Official Name and Position | Jae Hoon Lee (PRESIDENT / MD) |
| Authorized Official Contact | 3239175155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jae Hoon Lee MD Inc 4221 Wilshire Blvd Ste 311 Los Angeles CA 90010-3537 Ph: (323) 917-5155 | Jae Hoon Lee MD Inc 4221 Wilshire Blvd Ste 311 Los Angeles CA 90010-3537 Ph: (323) 917-5155 |
| NPI Number | 1548961204 |
|---|---|
| Provider Enumeration Date | 03/10/2023 |
| Last Update Date | 10/30/2025 |
| Certification Date | 10/30/2025 |
| Medicare PECOS PAC ID | 6608241732 |
|---|---|
| Medicare Enrollment ID | O20230403002811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548961204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | () | Primary |
| Provider Name | Jae H Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912105297 PECOS PAC ID: 1355513326 Enrollment ID: I20111017000706 |
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