Healthcare Provider Details

I. General information

NPI: 1932233772
Provider Name (Legal Business Name): SAHNGJOON LEE L.AC.,QME.,CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4680 S EASTERN AVE STE E
LAS VEGAS NV
89119-6192
US

IV. Provider business mailing address

4680 S EASTERN AVE STE E
LAS VEGAS NV
89119-6192
US

V. Phone/Fax

Practice location:
  • Phone: 725-272-7250
  • Fax: 702-209-0102
Mailing address:
  • Phone: 725-272-7250
  • Fax: 702-209-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: