Provider Demographics
NPI:1124233234
Name:LEE, KING YU
Entity Type:Individual
Prefix:
First Name:KING
Middle Name:YU
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 SCOTT ST
Mailing Address - Street 2:APT. # 301
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-1178
Mailing Address - Country:US
Mailing Address - Phone:415-441-6013
Mailing Address - Fax:
Practice Address - Street 1:3730 SCOTT ST
Practice Address - Street 2:APT. # 301
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-1178
Practice Address - Country:US
Practice Address - Phone:415-441-6013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 223171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist