Healthcare Provider Details

I. General information

NPI: 1164203436
Provider Name (Legal Business Name): ALBERT LEE L. AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ENDEAVOR STE 205
IRVINE CA
92618-3181
US

IV. Provider business mailing address

15969 ROSALITA DR
LA MIRADA CA
90638-4135
US

V. Phone/Fax

Practice location:
  • Phone: 562-783-8535
  • Fax:
Mailing address:
  • Phone: 562-783-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC19797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: