Choongbae Lee
Individual provider Active NPI Acupuncturist · Garden Grove, CA
NPI 1770063299 · NPPES record last updated Aug 14, 2018
Key facts
- NPI
- 1770063299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- AC16765 (CA)
- Practice address
- 12156 Adrian St Apt 9-312
Garden Grove, CA 92840-4379 - Phone
- (714) 603-2625
- NPI assigned
- Aug 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC16765 | CA | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC16765 | CA | Yes |
Addresses
Primary practice location
12156 Adrian St Apt 9-312
Garden Grove, CA 92840-4379
Mailing address
12156 Adrian St Apt 9-310
Garden Grove, CA 92840-4379
Other providers in Garden Grove, CA
- Boyea Lee
- Brian Lee
- Bum Soo Lee
- Cheryl Lee
- Chin-Jane R Lee
- Christine Lee
- Chungja Lee
- Clifford Suk-Jae Lee
- Connery Lee
- David Charles Lee
All providers in Garden Grove, CA · Acupuncturist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.