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General NPI Number Information
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NPI Number | 1447310628
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Entity Type | Individual
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Provider Name | NAM S LEE L.AC, PH.D
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1520 NUTMEG PL, SUITE103
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City | COSTA MESA
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State | CA
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Zip | 92626
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Country | US
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Telephone | 714-751-8110
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Fax |
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Provider Business Mailing Address
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Address Line | 430 32ND STREET SUITE100
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City | NEWPORT BEACH
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State | CA
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Zip | 92663
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Country | US
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Telephone | 213-820-3641
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Fax | 949-723-6129
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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 | AC8662
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License Number State | CA
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