MEDICARE: DR. SEAN TAEHO LEE DC

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	36938	CA

General Provider Information

NPI Number	:	1487491650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN TAEHO LEE DC

Provider Business Mailing Address
First Line	:	17125 S VERMONT AVE UNIT 12
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-5869
Country	:	US
Telephone Number	:	714-900-0695
Fax Number	:

Provider Business Practice Location Address
First Line	:	11121 LOS ALAMITOS BLVD STE 203
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3889
Country	:	US
Telephone Number	:	714-230-2443
Fax Number	:

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

Provider Enumeration Date	:	07/13/2024
Last Update Date	:	07/13/2024

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