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NPI 1477898294

NPI 1477898294 : SEOK LEE L. AC. : TUSTIN, CA

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General NPI Number Information
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    NPI Number           |    1477898294
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    Entity Type          |    Individual 
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    Provider Name        |    SEOK LEE L. AC.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/05/2012
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    Last Update Date     |    02/09/2022
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Provider Practice Location Address
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    Address Line         |    17501 IRVINE BLVD STE 103 
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    City                 |    TUSTIN
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    State                |    CA
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    Zip                  |    92780-3147
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    Country              |    US
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    Telephone            |    714-932-8512
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    Fax                  |    949-390-9902
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Provider Business Mailing Address
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    Address Line         |    17501 IRVINE BLVD STE 103 
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    City                 |    TUSTIN
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    State                |    CA
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    Zip                  |    92780-3147
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    Country              |    US
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    Telephone            |    714-932-8512
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    Fax                  |    949-390-9902
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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       |    AC15077
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    License Number State |    CA
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