Provider Demographics
NPI:1124405444
Name:DAE S. LEE, D.C. INC., A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:DAE S. LEE, D.C. INC., A CHIROPRACTIC CORPORATION
Other - Org Name:HOYT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAE
Authorized Official - Middle Name:SUP
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-600-8198
Mailing Address - Street 1:25285 MADISON AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8981
Mailing Address - Country:US
Mailing Address - Phone:951-600-8198
Mailing Address - Fax:951-698-4932
Practice Address - Street 1:25285 MADISON AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8981
Practice Address - Country:US
Practice Address - Phone:951-600-8198
Practice Address - Fax:951-698-4932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty