Provider Demographics
NPI:1215978804
Name:LEE, DAVID YONG (LAC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:YONG
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:166 N MOORPARK RD
Mailing Address - Street 2:#203
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4405
Mailing Address - Country:US
Mailing Address - Phone:805-497-6200
Mailing Address - Fax:805-497-6233
Practice Address - Street 1:166 N MOORPARK RD
Practice Address - Street 2:#203
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4405
Practice Address - Country:US
Practice Address - Phone:805-497-6200
Practice Address - Fax:805-497-6233
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC7417171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist