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General NPI Number Information
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NPI Number | 1215349873
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Entity Type | Individual
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Provider Name | JINHUR LEE LAC
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Gender | Male
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 1625 W OLYMPIC BLVD STE M103
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City | LOS ANGELES
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State | CA
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Zip | 90015-3824
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Country | US
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Telephone | 323-375-5147
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Fax | 323-523-3747
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Provider Business Mailing Address
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Address Line | PO BOX 546
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City | CARDIFF
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State | CA
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Zip | 92007-0546
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Country | US
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Telephone | 885-436-7600
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Fax | 760-797-1845
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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 | AC10299
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License Number State | CA
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