Provider Demographics
NPI:1902110281
Name:LEE, HYUN A (LAC PHD)
Entity Type:Individual
Prefix:DR
First Name:HYUN A
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7208 PACIFIC BLVD
Mailing Address - Street 2:#204
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255
Mailing Address - Country:US
Mailing Address - Phone:310-703-7385
Mailing Address - Fax:323-588-4941
Practice Address - Street 1:7208 PACIFIC BLVD
Practice Address - Street 2:#204
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255
Practice Address - Country:US
Practice Address - Phone:310-703-7385
Practice Address - Fax:323-588-4941
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12993171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist