Provider Demographics
NPI:1215240668
Name:LEE, SANGIK
Entity type:Individual
Prefix:DR
First Name:SANGIK
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 S BURNSIDE AVE
Mailing Address - Street 2:#4H
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5470
Mailing Address - Country:US
Mailing Address - Phone:213-700-4746
Mailing Address - Fax:
Practice Address - Street 1:386 S BURNSIDE AVE
Practice Address - Street 2:#4H
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5470
Practice Address - Country:US
Practice Address - Phone:213-700-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program