Kwang Yeon Carol Lee
Nurse Practitioner, Acute Care in Orange, CA. Individual provider (NPI-1).
NPI number1164022448
StatusActive
Last updated in NPPESOct 27, 2020
Details
- NPI
- 1164022448
- Entity type
- Individual (NPI-1)
- Name
- Kwang Yeon Carol Lee
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 27, 2020
- Certification date
- Oct 27, 2020
- Last updated
- Oct 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 95015771 | CA | Yes |
Practice location
101 The City Dr SOrange, CA 92868-3298
Phone 714-880-7812
Mailing address
2119 Winterwood DrFullerton, CA 92833-1251
Phone 310-694-4318
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