Provider Demographics
NPI:1205348208
Name:KIM & LEE CHIROPRACTIC & ACUPUNCTURE CORPORATION
Entity type:Organization
Organization Name:KIM & LEE CHIROPRACTIC & ACUPUNCTURE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR, ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:310-961-4189
Mailing Address - Street 1:23000 CRENSHAW BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3052
Mailing Address - Country:US
Mailing Address - Phone:310-961-4189
Mailing Address - Fax:424-202-5486
Practice Address - Street 1:23000 CRENSHAW BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3052
Practice Address - Country:US
Practice Address - Phone:310-961-4189
Practice Address - Fax:424-202-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15716171100000X
CADC32505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty