Individual provider Active NPI

Hyungwon Lee, PHD, LAC

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1164076774
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
18592 Issued in CA
Practice address
1107 Crenshaw Blvd
Los Angeles, CA 90019-3112
Phone
(818) 732-0369
NPI assigned
Jul 31, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 18592 CA Primary

Addresses

Primary practice location

1107 Crenshaw Blvd
Los Angeles, CA 90019-3112

Mailing address

415 S Occidental Blvd Apt 212
Los Angeles, CA 90057-1579
Phone (213) 725-8915

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Provision Acupuncture Acupuncturist CurrentSince Jan 1, 2024 Accepting new patients
LN Wellness Acupuncture, Inc. Acupuncturist PastSince Jan 21, 2024 Accepting new patients
Spine Solution Chung Chiropractic, Inc. PastSince Oct 1, 2020 Accepting new patients
Beach Cities Orthopedics and Sports Medicine Past Accepting new patients
Spine Solution Chung Chiropractic Inc. PastSince Oct 1, 2020 Accepting new patients
Wellmate Dr Lee Chiropractic Clinic Inc PastSince Aug 1, 2020 Accepting new patients

Locations

3948 Wilshire Blvd
#200
Los Angeles, CA 90010
Phone (213) 725-8915

1107 Crenshaw Blvd
Los Angeles, CA 90019
Phone (323) 289-8601

Organizations & group practices 6

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1164076774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S OCCIDENTAL BLVD APT 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571579",
            "telephone_number": "213-725-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193112",
            "telephone_number": "818-732-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HYUNGWON",
        "name_prefix": "Dr.",
        "credential": "PHD, LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.