Provider Demographics
NPI:1730675380
Name:LEE, HYO SUB
Entity Type:Individual
Prefix:
First Name:HYO
Middle Name:SUB
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 1:24017 OAK KNOLL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-5138
Mailing Address - Country:US
Mailing Address - Phone:408-529-4947
Mailing Address - Fax:
Practice Address - Street 1:24017 OAK KNOLL CIR
Practice Address - Street 2:
Practice Address - City:LOS ALTOS HILLS
Practice Address - State:CA
Practice Address - Zip Code:94022-5138
Practice Address - Country:US
Practice Address - Phone:408-529-4947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18006171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist