Provider Demographics
NPI:1144386988
Name:LEE, THOMAS T (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:T
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2662
Mailing Address - Country:US
Mailing Address - Phone:626-337-6614
Mailing Address - Fax:626-376-9681
Practice Address - Street 1:741 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2662
Practice Address - Country:US
Practice Address - Phone:626-337-6614
Practice Address - Fax:626-376-9681
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25590111N00000X
CAAC14725171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor