| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JIN SONG LEE | 1508492448 | 2024-06-09 |
Jin Song Lee is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1508492448. Registration indicates Jin Song Lee is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Mental Health/Behavioral Health Providers (Allopathic & Osteopathic Physicians, Psychiatry & Neurology) (Allopathic & Osteopathic Physicians, Psychiatry & Neurology) (Psychiatry & Neurology: Psychiatry, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Psychiatry & Neurology Psychiatry, Allopathic & Osteopathic Physicians) (Psychiatry & Neurology, )
| Entity Type | Individual |
| Provider Name | Jin Song Lee DO |
| Practice Office Address | 86-260 FARRINGTON HWY WAIANAE, HI US |
| Practice Office Telephone | 8086973300 |
| Mailing Address | 3014 W CHARLESTON BLVD STE 130 LAS VEGAS, NV 891020083 US |
| Business Telephone | 7026715127 |
| Business Fax | 7026716440 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 86-260 Farrington Hwy | Waianae, HI 967923128 | 8086973300 |
| 3014 W Charleston Blvd Ste 130 | Las Vegas, NV 891020083 | 7026715127 / 7026716440 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 2084P0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Allopathic & Osteopathic Physicians Psychiatry & Neurology Allopathic & Osteopathic Physicians Psychiatry & Neurology Psychiatry & Neurology: Psychiatry Behavioral Health/Substance Abuse/Psychiatry Psychiatry & Neurology Psychiatry Allopathic & Osteopathic Physicians Psychiatry & Neurology | 2550
HI |