Provider Demographics
NPI:1831597848
Name:LEE, HO SEONG (LAC, DAOM)
Entity type:Individual
Prefix:
First Name:HO SEONG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1108
Mailing Address - Country:US
Mailing Address - Phone:213-383-0008
Mailing Address - Fax:213-389-0390
Practice Address - Street 1:3055 WILSHIRE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1108
Practice Address - Country:US
Practice Address - Phone:213-383-0008
Practice Address - Fax:213-389-0390
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10837171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist