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Jaesung Lee
Specialist in Thousand Oaks, California
NPI 1609072503

Jaesung Lee is a Specialist based in Thousand Oaks, CA. Jaesung Lee practices in Thousand Oaks, CA. The NPI Number for Jaesung Lee is 1609072503 and holds a License No. G64716 (California).

The current practice location address for Jaesung Lee is 301 S Moorpark Rd, Thousand Oaks, CA and can be reached out via phone at 805-379-9646 and via fax at 805-379-0611.

Location: 301 S Moorpark Rd, Thousand Oaks, CA, 91361-1008
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1609072503
Provider Name
Jaesung Lee
Credential
Provider Entity Type
Organization
Address
301 S Moorpark Rd, Thousand Oaks, CA, 91361-1008
Phone Number
805-379-9646
Fax Number
805-379-0611
Provider Enumeration Date
06/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
G64716 01 CA LICENSE
institution
Provider Business Practice Location Address Details
Address
301 S Moorpark Rd
City
Thousand Oaks
State
California
Zip
91361-1008
Phone Number
805-379-9646
Fax Number
805-379-0611
person
Provider Business Mailing Address Details
Address
301 S Moorpark Rd
City
Thousand Oaks
State
California
Zip
91361-1008
Phone Number
805-379-9646
Fax Number
805-379-0611
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G64716 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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