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General NPI Number Information
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NPI Number | 1962576405
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Entity Type | Individual
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Provider Name | SANG KUN LEE PHD, L.AC.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 50 BELLEFONTAINE ST STE 301
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City | PASADENA
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State | CA
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Zip | 91105-3132
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Country | US
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Telephone | 626-359-8889
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Fax | 626-305-3149
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Provider Business Mailing Address
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Address Line | 520 S KINGSLEY DR APT 307
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City | LOS ANGELES
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State | CA
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Zip | 90020-3510
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Country | US
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Telephone | 626-359-8889
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Fax | 626-305-3149
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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 | AC10623
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License Number State | CA
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