Individual provider Active NPI

Sang Y Lee, L.AC. PH.D.

  • Acupuncturist
  • Anaheim, CA
National Provider Identifier
1306485982
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC9953 Issued in CA
Practice address
3340 W Ball Rd Ste B
Anaheim, CA 92804-3729
Phone
(213) 365-8275
Fax
(714) 916-5100
NPI assigned
Dec 31, 2019
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC9953 CA Primary

Addresses

Primary practice location

3340 W Ball Rd Ste B
Anaheim, CA 92804-3729

Mailing address

3340 W Ball Rd Ste B
Anaheim, CA 92804-3729
Phone (213) 365-8275

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AC9953CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
White & Blue Wellness Inc. Acupuncturist CurrentSince Jun 25, 2023 Accepting new patients

Locations

3340 W Ball Rd
Ste B
Anaheim, CA 92804
Phone (213) 365-8275

1701 W Whittier Blvd
Montebello, CA 90640
Phone 2134839902512

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1306485982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 W BALL RD STE B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043729",
            "telephone_number": "213-365-8275",
            "fax_number": "714-916-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 W BALL RD STE B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043729",
            "telephone_number": "213-365-8275",
            "fax_number": "714-916-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANG",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "L.AC. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-31",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC9953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.