Provider Demographics
NPI:1194889972
Name:LEE, YOUNG HUN (MD)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:HUN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 W GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-4364
Mailing Address - Country:US
Mailing Address - Phone:951-737-5809
Mailing Address - Fax:951-848-6923
Practice Address - Street 1:1157 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4364
Practice Address - Country:US
Practice Address - Phone:951-737-5809
Practice Address - Fax:951-848-6923
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99013207R00000X, 207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3331837Medicaid
CAA99013OtherMEDICAL LICENSE
CAFL0170972OtherDEA
CAA99013OtherMEDICAL LICENSE
CA00A990130Medicare PIN