Healthcare Provider Details

I. General information

NPI: 1912046145
Provider Name (Legal Business Name): ERIC LEE CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2848 SEPULVEDA BLVD
TORRANCE CA
90505-2803
US

IV. Provider business mailing address

2848 SEPULVEDA BLVD
TORRANCE CA
90505-2803
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-7246
  • Fax:
Mailing address:
  • Phone: 310-325-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number25160
License Number StateCA

VIII. Authorized Official

Name: DR. ERIC GIM LEE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 310-325-7246