Individual provider Active NPI

Il Ju Lee, L. AC.

  • Acupuncturist
  • Irvine, CA
National Provider Identifier
1952898298
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
16829 Issued in CA
Practice address
14785 Jeffrey Rd Ste 210
Irvine, CA 92618-0420
Phone
(949) 533-8084
NPI assigned
Apr 20, 2018
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 16829 CA Primary

Addresses

Primary practice location

14785 Jeffrey Rd Ste 210
Irvine, CA 92618-0420

Mailing address

59 Havenwood
Irvine, CA 92614-5436
Phone (949) 514-4945

Other practice location 1

59 Havenwood
Irvine, CA 92614-5436
Phone (949) 514-4945

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

LicenseStateTypeSpecialty
16829CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Alternative Medical Group, Inc. Acupuncturist Current Accepting new patients
Dna Holistic Acupuncture Clinic Acupuncturist Past Accepting new patients
Wooree Alternative Medical Group Inc. Acupuncturist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1952898298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 HAVENWOOD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145436",
            "telephone_number": "949-514-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14785 JEFFREY RD STE 210",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180420",
            "telephone_number": "949-533-8084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Havenwood",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926145436",
            "country_code": "US",
            "telephone_number": "949-514-4945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "IL JU",
        "credential": "L. AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.