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NPI Code Detail

MEDICARE: MRS. YEOJIN LEE

MEDICARE: MRS. YEOJIN LEE
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
1171100000XAcupuncturistAC16026CA

General Provider Information

NPI Number : 1356892368
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YEOJIN LEE
Provider Business Mailing Address
First Line : 2069 ARGYLE AVE APT 510
Second Line :
City : LOS ANGELES
State : CA
Zip : 90068-1093
Country : US
Telephone Number : 213-446-5852
Fax Number :
Provider Business Practice Location Address
First Line : 2511 COLORADO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90041-1004
Country : US
Telephone Number : 213-446-5852
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2016
Last Update Date : 10/14/2016

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Directions to “ MRS. YEOJIN LEE ” Practice Location

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