Provider Demographics
NPI:1215267547
Name:KANG & LEE CHIROPRACTIC INC
Entity type:Organization
Organization Name:KANG & LEE CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYUNG
Authorized Official - Middle Name:YI
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-732-8343
Mailing Address - Street 1:3511 W OLYMPIC BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3563
Mailing Address - Country:US
Mailing Address - Phone:323-732-8343
Mailing Address - Fax:323-732-8344
Practice Address - Street 1:3511 W OLYMPIC BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3563
Practice Address - Country:US
Practice Address - Phone:323-732-8343
Practice Address - Fax:323-732-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30611111N00000X
CADC-30443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty