Andrew Jaejun Lee, MSTCM, DACM, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

18116 Issued in CA

Practice address

3980 San Pablo Dam Rd Ste 205
El Sobrante, CA 94803

Phone

(510) 730-0340

NPI assigned

May 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1831680446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 PARK CENTRAL ST",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948031226",
            "telephone_number": "510-520-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SAN PABLO DAM RD STE 205",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "94803",
            "telephone_number": "510-730-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDREW",
        "middle_name": "JAEJUN",
        "name_prefix": "Dr.",
        "credential": "MSTCM, DACM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Kohnen, MFT
• Nicole Marie Koprek
• La Cheim School, Inc. (La Cheim - Richmond/El Sobrante School)
• Xavier Renzo Dedios Lamorena
• Rashon Lane, PHD
• Annika Leitner
• Leslie Rocio Leiva-Aguilar
• Katherine Lenschau, MOT, OTR/L
• Linda Kathryn Low, D.D.S.
• Samantha Adele Luna

• Acupuncturist in El Sobrante, CA
• Providers in El Sobrante, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.