Provider Demographics
NPI:1194165076
Name:LEE, EUNHAN (ACUPUNCTURIST)
Entity type:Individual
Prefix:MR
First Name:EUNHAN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 EL CAMINO WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4006
Mailing Address - Country:US
Mailing Address - Phone:650-815-8251
Mailing Address - Fax:
Practice Address - Street 1:4161 EL CAMINO WAY
Practice Address - Street 2:SUITE A
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4006
Practice Address - Country:US
Practice Address - Phone:650-815-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15219171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist