Provider Demographics
NPI:1003329350
Name:RHEE, MI-YUNG LISA (LAC, DAOM)
Entity Type:Individual
Prefix:DR
First Name:MI-YUNG
Middle Name:LISA
Last Name:RHEE
Suffix:
Gender:F
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 JETTY DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-4223
Mailing Address - Country:US
Mailing Address - Phone:510-230-4272
Mailing Address - Fax:
Practice Address - Street 1:125 W RICHMOND AVE STE D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3950
Practice Address - Country:US
Practice Address - Phone:510-974-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17487171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist