| Se-young Lee MD Inc | |
|
12665 Garden Grove Blvd Ste 203 Garden Grove CA 92843-1916 | |
| (714) 468-5490 | |
| Not Available |
| Full Name | Se-young Lee MD Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12665 Garden Grove Blvd Ste 203, Garden Grove, California |
| Authorized Official Name and Position | Se-young Lee (PRESIDENT/MD) |
| Authorized Official Contact | 7145318711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Se-young Lee MD Inc Po Box 2556 Garden Grove CA 92842-2556 Ph: (714) 531-8711 | Se-young Lee MD Inc 12665 Garden Grove Blvd Ste 203 Garden Grove CA 92843-1916 Ph: (714) 468-5490 |
| NPI Number | 1366837593 |
|---|---|
| Provider Enumeration Date | 04/03/2015 |
| Last Update Date | 09/29/2022 |
| Certification Date | 09/29/2022 |
| Medicare PECOS PAC ID | 2668785668 |
|---|---|
| Medicare Enrollment ID | O20150720003314 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366837593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Se-young Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144336967 PECOS PAC ID: 7012220015 Enrollment ID: I20150720003344 |
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