Myeong Jae Lee, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

14772 Issued in CA

Practice address

6540 Lusk Blvd Ste C139
San Diego, CA 92121-2696

Phone

(619) 337-4096

Fax

(858) 348-8091

NPI assigned

Feb 24, 2015

Last updated

Jan 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Om Acupuncture Wellness, Inc

  • Acupuncturist
  • San Diego, CA
  • NPI 1598495269
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1033501234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD STE C139",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212696",
            "telephone_number": "619-337-4096",
            "fax_number": "858-348-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD STE C139",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212696",
            "telephone_number": "619-337-4096",
            "fax_number": "858-348-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYEONG JAE",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-24",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "14772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Min Dennis Lee, DDS
• Mindy Amanda Lee, NP
• Monica Lee
• Monica Haewon Lee, DMD
• Moon Soo Lee, MD
• Nancy Sue Lee, M.D.
• Natalie Lee, MS, CCC-SLP
• Nathan Lee, O.D.
• Nayun Lee, MD
• Nicholas Michael Lee, IDC

• Acupuncturist in San Diego, CA
• Providers in San Diego, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.