Provider Demographics
NPI:1285005843
Name:LEE, HSUN (MS TCM)
Entity Type:Individual
Prefix:MS
First Name:HSUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MS TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4683 VENTURA AVE
Mailing Address - Street 2:6055 MERIDIAN AVE, STE 30
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-2678
Mailing Address - Country:US
Mailing Address - Phone:408-446-1996
Mailing Address - Fax:
Practice Address - Street 1:6055 MERIDIAN AVE STE 30
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2700
Practice Address - Country:US
Practice Address - Phone:408-446-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16654171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist