MEDICARE: DR. TONG G LEE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	24738	CA

General Provider Information

NPI Number	:	1962662163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONG G LEE DC

Provider Business Mailing Address
First Line	:	4590 RIVERSIDE DR
Second Line	:	SUITE A
City	:	CHINO
State	:	CA
Zip	:	91710-3980
Country	:	US
Telephone Number	:	909-591-1010
Fax Number	:	909-591-6767

Provider Business Practice Location Address
First Line	:	4590 RIVERSIDE DR
Second Line	:	SUITE A
City	:	CHINO
State	:	CA
Zip	:	91710-3980
Country	:	US
Telephone Number	:	909-591-1010
Fax Number	:	909-591-6767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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Directions to “ DR. TONG G LEE DC” Practice Location

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