Individual provider Active NPI

Sejin Lee

  • Acupuncturist
  • Fullerton, CA
National Provider Identifier
1093053001
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
11685 Issued in CA
Practice address
1418 S Euclid St
Fullerton, CA 92832-3135
Phone
(714) 578-0580
Fax
(714) 578-0585
NPI assigned
Jan 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 11685 CA Primary

Addresses

Primary practice location

1418 S Euclid St
Fullerton, CA 92832-3135

Mailing address

1418 S Euclid St
Fullerton, CA 92832-3135
Phone (714) 578-0580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11685CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dunamis Acupuncture & Herb Clinic, Inc Acupuncturist CurrentSince Sep 13, 2020 Accepting new patients
Dunamis Acupuncture & Herb Clinic, Inc Acupuncturist CurrentSince Sep 13, 2020 Accepting new patients

Locations

1335 W Valencia Dr
Ste M
Fullerton, CA 92833
Phone (209) 694-4788

1418 S Euclid St
Fullerton, CA 92832
Phone (714) 578-0580

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1093053001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 S EUCLID ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928323135",
            "telephone_number": "714-578-0580",
            "fax_number": "714-578-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 S EUCLID ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928323135",
            "telephone_number": "714-578-0580",
            "fax_number": "714-578-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEJIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-25",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.