Provider Demographics
NPI:1447456926
Name:LEE, JOHN SANG JIN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SANG JIN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:FILE 1440
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91199-1440
Mailing Address - Country:US
Mailing Address - Phone:858-436-5027
Mailing Address - Fax:
Practice Address - Street 1:7901 FROST ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY, SHARP MEMORIAL HOSPITAL
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2701
Practice Address - Country:US
Practice Address - Phone:858-436-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87022207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFE604ZMedicare PIN