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NPI 1215415849

NPI 1215415849 : JUN BUM LEE L.AC : SCOTTSDALE, AZ

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General NPI Number Information
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    NPI Number           |    1215415849
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    Entity Type          |    Individual 
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    Provider Name        |    JUN BUM LEE L.AC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/06/2018
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    Last Update Date     |    08/24/2018
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Provider Practice Location Address
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    Address Line         |    7331 E OSBORN DR STE 420 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85251
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    Country              |    US
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    Telephone            |    480-372-4104
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    Fax                  |    480-372-4923
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Provider Business Mailing Address
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    Address Line         |    7331 E OSBORN DR STE 420 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85251-6415
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    Country              |    US
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    Telephone            |    480-372-4104
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    Fax                  |    480-372-4923
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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       |    1137
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    License Number State |    AZ
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