Healthcare Provider Details

I. General information

NPI: 1689589962
Provider Name (Legal Business Name): LN WELLNESS ACUPUNCTURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 CRENSHAW BLVD
LOS ANGELES CA
90019-3112
US

IV. Provider business mailing address

415 S OCCIDENTAL BLVD APT 212
LOS ANGELES CA
90057-1579
US

V. Phone/Fax

Practice location:
  • Phone: 818-732-0369
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. HYUNGWON LEE
Title or Position: CEO
Credential: PHD, LAC
Phone: 213-725-8915