Active NPI
Hae Won Lee, LA C
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1477851368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC12205
- Practice address
- 4055 Wilshire Blvd Ste 302
Los Angeles, CA 90010-3403 - Phone
- (213) 756-4788
- NPI assigned
- Mar 2, 2011
- Sex
- Female
- 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 | AC12205 | CA | Primary |
Addresses
Primary practice location
4055 Wilshire Blvd Ste 302
Los Angeles, CA 90010-3403
Mailing address
1401 W 169TH St Apt 5
Gardena, CA 90247-5451
Phone (213) 756-4788
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC12205 | Other | CA | LICENSED ACUPUNCTURIST |
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 |
|---|---|---|---|
| AC12205 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724457600000",
"number": "1477851368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 W 169TH ST APT 5",
"city": "GARDENA",
"state": "CA",
"postal_code": "902475451",
"telephone_number": "213-756-4788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 WILSHIRE BLVD STE 302",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103403",
"telephone_number": "213-756-4788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "HAE WON",
"name_prefix": "Ms.",
"credential": "LA C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-02",
"last_updated": "2024-08-24",
"certification_date": "2024-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC12205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED ACUPUNCTURIST",
"identifier": "AC12205",
"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 Aug 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.