Provider Demographics
NPI:1194840611
Name:LEE, BENJAMIN YON (L AC)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:YON
Last Name:LEE
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 S. OXFORD AVE #202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-5172
Mailing Address - Country:US
Mailing Address - Phone:213-384-8438
Mailing Address - Fax:213-384-8438
Practice Address - Street 1:258 S. OXFORD AVE #202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-5172
Practice Address - Country:US
Practice Address - Phone:213-384-8438
Practice Address - Fax:213-384-8438
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5822171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist