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General NPI Number Information
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NPI Number | 1790006211
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Entity Type | Individual
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Provider Name | JOO H LEE L.AC.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 4465 WILSHIRE BLVD # 202 (LIVIWELL)
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City | LOS ANGELES
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State | CA
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Zip | 90010-3704
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Country | US
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Telephone | 323-936-5484
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Fax | 323-954-9355
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Provider Business Mailing Address
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Address Line | 4465 WILSHIRE BLVD. # 202 (LIVIWELL)
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City | LOS ANGELES
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State | CA
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Zip | 90010
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Country | US
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Telephone | 323-936-5484
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Fax | 323-954-9355
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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 | 12917
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License Number State | CA
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