Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jae Yong Lee, PT, DPT, CSCS, TSACF

Individual provider Physical Therapist · NPI 1639833312

Dr. Jae Yong Lee, PT, DPT, CSCS, TSACF is a Physical Therapist in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone: (310) 478-3711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT300566 (CA)

Record details

NPI number1639833312
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT , CSCS , TSACF
Sole proprietorYes
NPI enumeratedOctober 28, 2021
Last updated in NPPESOctober 28, 2021
Certification dateOctober 28, 2021

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