Healthcare Provider Details

I. General information

NPI: 1992618615
Provider Name (Legal Business Name): JIEMINBRANDON LEE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BRANDON JIEMIN LEE DC

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7218 HUGHSON AVE
HUGHSON CA
95326
US

IV. Provider business mailing address

PO BOX 1455
HUGHSON CA
95326-1455
US

V. Phone/Fax

Practice location:
  • Phone: 209-883-0415
  • Fax: 209-882-9050
Mailing address:
  • Phone: 209-883-0415
  • Fax: 209-882-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number37224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: