Provider Demographics
NPI:1184115578
Name:LEE, SANG DO (DC)
Entity type:Individual
Prefix:DR
First Name:SANG
Middle Name:DO
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:8362 ARTESIA BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-4177
Mailing Address - Country:US
Mailing Address - Phone:714-381-1777
Mailing Address - Fax:714-707-3031
Practice Address - Street 1:8362 ARTESIA BLVD
Practice Address - Street 2:STE C
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4177
Practice Address - Country:US
Practice Address - Phone:714-381-1777
Practice Address - Fax:714-707-3031
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC34089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor