Provider Demographics
NPI:1487925707
Name:LEE, ALEX BYUNGCHOON (LAC)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:BYUNGCHOON
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18007 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9033
Mailing Address - Country:US
Mailing Address - Phone:714-234-6221
Mailing Address - Fax:
Practice Address - Street 1:1145 E SAN ANTONIO DR STE A
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2379
Practice Address - Country:US
Practice Address - Phone:714-234-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14153171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist