MEDICARE: YOUNG SUK LEE 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	171100000X	Acupuncturist	AC 5649	CA

General Provider Information

NPI Number	:	1144393026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG SUK LEE LAC

Provider Business Mailing Address
First Line	:	15346 SAN FERNANDO MISSION BLVD
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1122
Country	:	US
Telephone Number	:	818-361-0997
Fax Number	:

Provider Business Practice Location Address
First Line	:	15346 SAN FERNANDO MISSION BLVD
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1122
Country	:	US
Telephone Number	:	818-361-0997
Fax Number	:

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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Directions to “ YOUNG SUK LEE LAC” Practice Location

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