Individual provider Active NPI

Dong Whan Lee, D.C.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1972717155
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28115 Issued in CA
Practice address
6330 San Vicente Blvd Ste 310
Los Angeles, CA 90048-5468
Phone
(310) 855-0751
Fax
(310) 358-2460
NPI assigned
May 9, 2007
Last updated
Aug 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28115 CA Primary

Addresses

Primary practice location

6330 San Vicente Blvd Ste 310
Los Angeles, CA 90048-5468

Mailing address

6330 San Vicente Blvd Ste 310
Los Angeles, CA 90048-5468
Phone (310) 855-0751

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1972717155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 SAN VICENTE BLVD STE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485468",
            "telephone_number": "310-855-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 SAN VICENTE BLVD STE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485468",
            "telephone_number": "310-855-0751",
            "fax_number": "310-358-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DONG WHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 8, 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.