Provider Demographics
NPI:1962660126
Name:CHOU, LEE (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:
Last Name:CHOU
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S WILTON PL APT 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-3285
Mailing Address - Country:US
Mailing Address - Phone:213-321-7942
Mailing Address - Fax:
Practice Address - Street 1:610 S WILTON PL APT 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-3285
Practice Address - Country:US
Practice Address - Phone:213-321-7942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 25845OtherCALIFORNIA BOARD OF CHIROPRACTIC EXAMINERS