MEDICARE: HENRY LEE HEALTH & ACUPUNCTURE CORP.

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	261QH0100X	Health Service Clinic/Center	AC9159	CA

General Provider Information

NPI Number	:	1740509132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY LEE HEALTH & ACUPUNCTURE CORP.

Provider Business Mailing Address
First Line	:	2037 CRONER PL
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2565
Country	:	US
Telephone Number	:	408-891-8091
Fax Number	:

Provider Business Practice Location Address
First Line	:	2037 CRONER PL
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2565
Country	:	US
Telephone Number	:	408-891-8091
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YEONG-CHENG LEE
Credential	:
Telephone Number	:	408-891-8091

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	05/25/2010

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