MEDICARE: HYUK WON 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	AC9468	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AC9468	OTHER	CA	CA LICENSE

General Provider Information

NPI Number	:	1972788503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYUK WON LEE L.AC

Provider Business Mailing Address
First Line	:	3407 W 6TH ST
Second Line	:	615
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2553
Country	:	US
Telephone Number	:	323-730-9900
Fax Number	:	213-344-5641

Provider Business Practice Location Address
First Line	:	3407 W 6TH ST
Second Line	:	615
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2553
Country	:	US
Telephone Number	:	323-730-9900
Fax Number	:	213-344-5641

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	04/15/2016

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Directions to “ HYUK WON LEE L.AC” Practice Location

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