MEDICARE: DR. KIRBY KWOK YUNG LEE D.C., LAC,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC28117	CA
2	171100000X	Acupuncturist	AC10621	CA

General Provider Information

NPI Number	:	1124169990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRBY KWOK YUNG LEE D.C., LAC,

Provider Business Mailing Address
First Line	:	333 W GARVEY AVE
Second Line	:	#B546
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7430
Country	:	US
Telephone Number	:	626-512-4578
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 NORTH GARFIELD AVE.
Second Line	:	# 103
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-3556
Country	:	US
Telephone Number	:	626-404-7373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	03/27/2012

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