Active NPI
Jae Koo Lee, L.AC.
- Acupuncturist
- Norwalk, CA
National Provider Identifier
1790934370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 12618
- Practice address
- 13821 San Antonio Dr
Norwalk, CA 90650-4034 - Phone
- (213) 258-5610
- NPI assigned
- Sep 18, 2008
- 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 | 12618 | CA | Primary |
Addresses
Primary practice location
13821 San Antonio Dr
Norwalk, CA 90650-4034
Mailing address
13821 San Antonio Dr
Norwalk, CA 90650-4034
Phone (213) 258-5610
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": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221696000000",
"number": "1790934370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13821 SAN ANTONIO DR",
"city": "NORWALK",
"state": "CA",
"postal_code": "906504034",
"telephone_number": "213-258-5610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13821 SAN ANTONIO DR",
"city": "NORWALK",
"state": "CA",
"postal_code": "906504034",
"telephone_number": "213-258-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JAE KOO",
"name_prefix": "Mr.",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-18",
"last_updated": "2008-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "12618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.