Provider Demographics
NPI:1952867756
Name:LEE, HWA Z (LAC)
Entity Type:Individual
Prefix:
First Name:HWA
Middle Name:Z
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12942 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4744
Mailing Address - Country:US
Mailing Address - Phone:714-534-7770
Mailing Address - Fax:714-534-7770
Practice Address - Street 1:12942 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4744
Practice Address - Country:US
Practice Address - Phone:714-534-7770
Practice Address - Fax:714-534-7770
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC2485171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist