Active NPI
Jae Lee
- Acupuncturist
- Pacoima, CA
National Provider Identifier
1205241320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC9097
- Practice address
- 12411 Osborne St
Unit 45
Pacoima, CA 91331-2000 - Phone
- (213) 435-8309
- NPI assigned
- Jun 26, 2014
- Last updated
- Dec 15, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC9097 | CA | Primary |
Addresses
Primary practice location
12411 Osborne St
Unit 45
Pacoima, CA 91331-2000
Mailing address
12411 Osborne St
Unit 45
Pacoima, CA 91331-2000
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC9097 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481760000000",
"number": "1205241320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12411 OSBORNE ST",
"address_2": "UNIT 45",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913312000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12411 OSBORNE ST",
"address_2": "UNIT 45",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913312000",
"telephone_number": "213-435-8309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JAE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-26",
"last_updated": "2016-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC9097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacoima, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.