Individual provider Active NPI

Myungjae Lee, L.AC.

  • Acupuncturist
  • Simi Valley, CA
National Provider Identifier
1730362310
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11994 Issued in CA
Practice address
2045 Royal Ave
#101
Simi Valley, CA 93065-4665
Phone
(805) 527-2754
NPI assigned
Dec 6, 2007
Last updated
Nov 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11994 CA Primary

Addresses

Primary practice location

2045 Royal Ave
#101
Simi Valley, CA 93065-4665

Mailing address

38431 5TH St W
#H-142
Palmdale, CA 93551-4277
Phone (213) 500-0532

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

LicenseStateTypeSpecialty
AC11994CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acuhealing Clinics Acupuncturist Past Accepting new patients
Acumen Health Clinics Acupuncturist Past Accepting new patients

Organizations & group practices 2

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": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1730362310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38431 5TH ST W",
            "address_2": "#H-142",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514277",
            "telephone_number": "213-500-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE",
            "address_2": "#101",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654665",
            "telephone_number": "805-527-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYUNGJAE",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.