Provider Demographics
NPI:1306045802
Name:LEE, JIMMY KYUNG (MD)
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:KYUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 OCEANO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-1865
Mailing Address - Country:US
Mailing Address - Phone:949-878-3258
Mailing Address - Fax:949-825-5112
Practice Address - Street 1:139 OCEANO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-1865
Practice Address - Country:US
Practice Address - Phone:949-878-3258
Practice Address - Fax:949-825-5112
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118202207WX0120X
CT046742207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist