MR. JIMMY SEUNG-SUP LEE - NPI 1689334930 - Registered Nurse in Mammoth Lakes, CA

Q: What is Jimmy Lee's NPI number?

The NPI number for Jimmy Lee is 1689334930. It was assigned to this individual provider in the NPPES registry on December 28, 2021.

Q: What is Jimmy Lee's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Psychiatric/Mental Health, with taxonomy code 163WP0808X.

Q: When was this NPI record last updated?

The NPPES record for Jimmy Lee was last updated on December 28, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mr. Jimmy Seung-sup Lee NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JIMMY SEUNG-SUP LEE (NPI 1689334930) is an individual psychiatric/mental health provider in Mammoth Lakes, California, licensed in California (790804) and active in the NPI registry since December 2021.

NPPES Registry Identity

NPI1689334930

Entity TypeIndividualMale

Primary Taxonomy163WP0808X

Provider Legal NameMR. JIMMY SEUNG-SUP LEE

Location Address1290 TAVERN RDMammoth Lakes, CA 93546-6601

Mailing AddressPo Box 100 Pmb 352Mammoth Lakes, CA 93546 · (310) 422-8005

Phone(760) 924-1740

Sole ProprietorNo

Enumeration DateDecember 28, 2021

NPPES CertifiedDecember 28, 2021

✔ NPI 1689334930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental HealthNursing Service Providers

Taxonomy Code163WP0808X

License✔ Licensed in CA · 790804

1290 TAVERN RD, Mammoth Lakes, CA 93546

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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