Healthcare Provider Details

I. General information

NPI: 1205348208
Provider Name (Legal Business Name): KIM & LEE CHIROPRACTIC & ACUPUNCTURE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23000 CRENSHAW BLVD STE 104
TORRANCE CA
90505-3052
US

IV. Provider business mailing address

23000 CRENSHAW BLVD STE 104
TORRANCE CA
90505-3052
US

V. Phone/Fax

Practice location:
  • Phone: 310-961-4189
  • Fax: 424-202-5486
Mailing address:
  • Phone: 310-961-4189
  • Fax: 424-202-5486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC32505
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC15716
License Number StateCA

VIII. Authorized Official

Name: DR. JULIANNE S. LEE
Title or Position: CHIROPRACTOR, ACUPUNCTURIST
Credential: DC, L.AC
Phone: 310-961-4189