Provider Demographics
NPI:1538307368
Name:LEE, YANG HUN
Entity Type:Individual
Prefix:
First Name:YANG
Middle Name:HUN
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14351 RED HILL AVE.
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6271
Mailing Address - Country:US
Mailing Address - Phone:949-679-7494
Mailing Address - Fax:714-544-0099
Practice Address - Street 1:14351 RED HILL AVE.
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6271
Practice Address - Country:US
Practice Address - Phone:949-679-7494
Practice Address - Fax:714-544-0099
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10629171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC10629OtherACUPUNCTURE