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General NPI Number Information
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NPI Number | 1083791065
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Entity Type | Individual
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Provider Name | SUE O LEE D.C., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 4221 WILSHIRE BLVD STE 284
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City | LOS ANGELES
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State | CA
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Zip | 90010-3509
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Country | US
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Telephone | 818-751-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 29121 N WEST HILLS DR
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City | VALENCIA
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State | CA
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Zip | 91354-3058
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Country | US
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Telephone | 818-751-9933
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038008478
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 18665
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License Number State | CA
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