Provider Demographics
NPI:1518126051
Name:LEE, WEON SEOB SEOB (LAC, PHD)
Entity Type:Individual
Prefix:MR
First Name:WEON SEOB
Middle Name:SEOB
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:MR
Other - First Name:WEON
Other - Middle Name:SEOB
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, PHD
Mailing Address - Street 1:363 SAN MIGUEL DR.
Mailing Address - Street 2:STE. 101
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-767-0774
Mailing Address - Fax:949-767-0775
Practice Address - Street 1:363 SAN MIGUEL DR.
Practice Address - Street 2:STE. 101
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-767-0774
Practice Address - Fax:949-767-0775
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2095171100000X
CAAC9142171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist