Active NPI
Seung Jin Lee, DAOM
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1225324221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 11777
- Practice address
- 1704 W.Manchester Ave.
Suite 208
Los Angeles, CA 90047-3057 - Phone
- (213) 249-0112
- Fax
- (213) 388-1017
- NPI assigned
- Jun 28, 2011
- 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 | 11777 | CA | Primary |
Addresses
Primary practice location
1704 W.Manchester Ave.
Suite 208
Los Angeles, CA 90047-3057
Mailing address
1704 W.Manchester Ave.
Suite 208
Los Angeles, CA 90047-3057
Phone (213) 249-0112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9725740 | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1225324221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 W.MANCHESTER AVE.",
"address_2": "SUITE 208",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900473057",
"telephone_number": "213-249-0112",
"fax_number": "213-388-1017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 W.MANCHESTER AVE.",
"address_2": "SUITE 208",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900473057",
"telephone_number": "213-249-0112",
"fax_number": "213-388-1017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SEUNG JIN",
"name_prefix": "Dr.",
"credential": "DAOM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-28",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "11777",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9725740",
"state": "CA"
}
],
"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 Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.