Provider Demographics
NPI:1386859734
Name:LEE, YOOCHEOL (LAC)
Entity Type:Individual
Prefix:DR
First Name:YOOCHEOL
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:DR
Other - First Name:YOOCHEOL
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:30313 CANWOOD ST
Mailing Address - Street 2:SUITE 23
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4326
Mailing Address - Country:US
Mailing Address - Phone:818-889-8988
Mailing Address - Fax:
Practice Address - Street 1:30313 CANWOOD ST
Practice Address - Street 2:SUITE 23
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4326
Practice Address - Country:US
Practice Address - Phone:818-889-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11118171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist