Healthcare Provider Details

I. General information

NPI: 1093875643
Provider Name (Legal Business Name): HWASOOK LEE-NEWMAN O.M.D.,L.AC.,R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 N KAWEAH AVE
EXETER CA
93221-1221
US

IV. Provider business mailing address

341 N KAWEAH AVE
EXETER CA
93221-1221
US

V. Phone/Fax

Practice location:
  • Phone: 559-592-7441
  • Fax:
Mailing address:
  • Phone: 559-592-7441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberCU3074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: