Healthcare Provider Details

I. General information

NPI: 1154240828
Provider Name (Legal Business Name): HANA LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 IRVINE BLVD STE 204
IRVINE CA
92620-1960
US

IV. Provider business mailing address

4940 IRVINE BLVD STE 204
IRVINE CA
92620-1960
US

V. Phone/Fax

Practice location:
  • Phone: 714-832-1500
  • Fax:
Mailing address:
  • Phone: 714-832-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20676
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: