Provider Demographics
NPI:1568663631
Name:LEE, PING PING (LAC)
Entity Type:Individual
Prefix:MS
First Name:PING PING
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 E REMINGTON DR
Mailing Address - Street 2:APT #204
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2654
Mailing Address - Country:US
Mailing Address - Phone:408-830-1160
Mailing Address - Fax:408-830-1160
Practice Address - Street 1:550 LAKESIDE DR
Practice Address - Street 2:SUITE 8 A
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4090
Practice Address - Country:US
Practice Address - Phone:408-530-9881
Practice Address - Fax:408-530-9881
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 11434171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist