Lee, Jaesung
Lee, Jaesung is an sole proprietor health care provider with primary practice located at 301 S Moorpark Rd , Thousand Oaks CA 91361-1008. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Lee, Jaesung can be contacted via phone (805) 379-9646.Contact Information
Primary practice address
301 S Moorpark Rd
Thousand Oaks CA 91361-1008
Phone: (805) 379-9646
Fax: (805) 379-0611
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | G64716 | California |
Profile Details
| NPI number | 1376550715 |
|---|---|
| LBN Legal business name | Lee, Jaesung |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Nov 9th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376550715 | NPPES |
| California | Other | P00957561 | MEDICARE RAILROAD |
| California | Other | G64716 | MEDICARE RAILROAD |
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