Provider Demographics
NPI:1043425861
Name:LEE, LUKE JOO (PH,D)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:JOO
Last Name:LEE
Suffix:
Gender:M
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7342 ORANGETHORPE AVE STE A212
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-4542
Mailing Address - Country:US
Mailing Address - Phone:714-638-8246
Mailing Address - Fax:714-562-9133
Practice Address - Street 1:7342 ORANGETHORPE AVE STE A212
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4542
Practice Address - Country:US
Practice Address - Phone:714-638-8246
Practice Address - Fax:714-562-9133
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist