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General NPI Number Information
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NPI Number | 1912223520
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Entity Type | Individual
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Provider Name | HENRY JUN WAH LEE L.AC.
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Gender | Male
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 05/23/2017
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Provider Practice Location Address
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Address Line | 453 S SPRING ST STE 320
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City | LOS ANGELES
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State | CA
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Zip | 90013-2072
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Country | US
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Telephone | 323-540-4180
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Fax |
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Provider Business Mailing Address
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Address Line | 453 S SPRING STREET SUITE 320
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City | LOS ANGELES
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State | CA
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Zip | 90013
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Country | US
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Telephone | 323-540-4180
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Fax |
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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 | AC 13439
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License Number State | CA
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