Provider Demographics
NPI:1619116530
Name:LEE, DAVID HYUN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HYUN
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 1:3510 1/2 OCEAN VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1285
Mailing Address - Country:US
Mailing Address - Phone:818-839-1336
Mailing Address - Fax:
Practice Address - Street 1:3510 1/2 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1285
Practice Address - Country:US
Practice Address - Phone:818-839-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60072117111N00000X
CA33602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor