Lee, Grace Jin

Lee, Grace Jin is an individual health care provider with primary practice located at 1950 Sunny Crest Dr Suite 2600, Fullerton CA 92835-3638. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Lee, Grace Jin can be contacted via phone (714) 446-5260.

Contact Information

Primary practice address
1950 Sunny Crest Dr Suite 2600 Fullerton CA 92835-3638
Phone: (714) 446-5260
Fax: (714) 446-5265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA16726 California

Profile Details

NPI number 1912961038
LBN Legal business name Lee, Grace Jin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jun 21st, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912961038 NPPES
California MEDICAID 00G471930

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