Provider Demographics
NPI:1508953837
Name:LEE, JUN HOUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:JUN
Middle Name:HOUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966 S WESTERN AVENUE
Mailing Address - Street 2:STE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006
Mailing Address - Country:US
Mailing Address - Phone:323-733-7424
Mailing Address - Fax:323-733-3843
Practice Address - Street 1:966 S WESTERN AVENUE
Practice Address - Street 2:STE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006
Practice Address - Country:US
Practice Address - Phone:323-733-7424
Practice Address - Fax:323-733-3843
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25744Medicare ID - Type Unspecified