Provider Demographics
NPI:1376290254
Name:LEE, JUNGHWA (LAC)
Entity Type:Individual
Prefix:MS
First Name:JUNGHWA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 E CHAPMAN AVE STE F
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3955
Mailing Address - Country:US
Mailing Address - Phone:714-752-0280
Mailing Address - Fax:
Practice Address - Street 1:1351 E CHAPMAN AVE STE F
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3955
Practice Address - Country:US
Practice Address - Phone:714-752-0280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty