Dr. Kwang Lee Wellness Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DR. KWANG LEE WELLNESS CENTER, INC.

Practice address

440 Shatto PL # 201-a
Los Angeles, CA 90020-1793

Phone

(213) 446-5935

NPI assigned

Jun 30, 2023

Last updated

Aug 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kwang Yup Lee, DC, LACNPI 1548960867

Title

Ceo

Phone

(213) 446-5935

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kwang Yup Lee, DC, LAC

  • Acupuncturist
  • Los Angeles, CA
  • NPI 1548960867

  Chiropractor

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691193600000",
    "number": "1811674849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SHATTO PL # 201-A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201793",
            "telephone_number": "213-446-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 SHATTO PL # 201-A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201793",
            "telephone_number": "213-446-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KWANG LEE WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-08-05",
        "certification_date": "2023-08-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KWANG",
        "authorized_official_middle_name": "YUP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-446-5935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, LAC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURIST",
            "identifier": "AC6428",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTOR",
            "identifier": "DC28510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.