Provider Demographics
NPI:1982964102
Name:LEE, VINCE SANG HOON (DC)
Entity Type:Individual
Prefix:MR
First Name:VINCE
Middle Name:SANG HOON
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S WESTERN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3831
Mailing Address - Country:US
Mailing Address - Phone:213-384-1042
Mailing Address - Fax:213-384-1043
Practice Address - Street 1:301 S WESTERN AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3831
Practice Address - Country:US
Practice Address - Phone:213-384-1042
Practice Address - Fax:213-384-1043
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor