Active NPI
Sangwook Lee, DC
- Chiropractor
- Los Angeles, CA
National Provider Identifier
1801417563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34381
- Practice address
- 680 S Berendo St Apt 529
Los Angeles, CA 90005-2087 - Phone
- (916) 260-6198
- NPI assigned
- May 4, 2020
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 34381 | CA | Primary |
Addresses
Primary practice location
680 S Berendo St Apt 529
Los Angeles, CA 90005-2087
Mailing address
17411 Irvine Blvd Ste H
Tustin, CA 92780-3025
Phone (916) 260-6198
Other names 1
- Dr. Jeff Lee
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 |
|---|---|---|---|
| 34381 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1801417563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17411 IRVINE BLVD STE H",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803025",
"telephone_number": "916-260-6198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 S BERENDO ST APT 529",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900052087",
"telephone_number": "916-260-6198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SANGWOOK",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-04",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEFF",
"last_name": "LEE",
"prefix": "DR.",
"credential": "DC",
"code": "2",
"type": "Professional Name"
}
]
}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 May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.