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General NPI Number Information
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NPI Number | 1043425861
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Entity Type | Individual
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Provider Name | LUKE JOO LEE PH,D
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 7342 ORANGETHORPE AVE STE A212
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City | BUENA PARK
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State | CA
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Zip | 90621-4542
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Country | US
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Telephone | 714-638-8246
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Fax | 714-562-9133
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Provider Business Mailing Address
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Address Line | 7342 ORANGETHORPE AVE STE A212
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City | BUENA PARK
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State | CA
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Zip | 90621-4542
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Country | US
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Telephone | 714-638-8246
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Fax | 714-562-9133
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC6413
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License Number State | CA
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