MEDICARE: MR. BENJAMIN YON LEE L. AC

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	AC5822	CA

General Provider Information

NPI Number	:	1194840611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN YON LEE L. AC

Provider Business Mailing Address
First Line	:	258 S. OXFORD AVE #202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-5172
Country	:	US
Telephone Number	:	213-384-8438
Fax Number	:	213-384-8438

Provider Business Practice Location Address
First Line	:	258 S. OXFORD AVE #202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-5172
Country	:	US
Telephone Number	:	213-384-8438
Fax Number	:	213-384-8438

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	09/10/2015

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