Provider Demographics
NPI:1467418434
Name:LEE, DENNIS Y (LAC PHD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:Y
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15026 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638
Mailing Address - Country:US
Mailing Address - Phone:562-902-1577
Mailing Address - Fax:562-902-1756
Practice Address - Street 1:15026 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638
Practice Address - Country:US
Practice Address - Phone:562-902-1577
Practice Address - Fax:562-902-1756
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5798171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist