Provider Demographics
NPI:1962656454
Name:LEE, HYUNSOOK I (LAC)
Entity Type:Individual
Prefix:MRS
First Name:HYUNSOOK
Middle Name:
Last Name:LEE
Suffix:I
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4482 BARRANCA PKWY STE 244
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4770
Mailing Address - Country:US
Mailing Address - Phone:714-415-8334
Mailing Address - Fax:949-313-0969
Practice Address - Street 1:4482 BARRANCA PKWY STE 244
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4770
Practice Address - Country:US
Practice Address - Phone:714-415-8334
Practice Address - Fax:949-313-0969
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist