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Organization
PROVISION ACUPUNCTURE
Active
Organization
PROVISION ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HYUNGWON LEE PHD, LAC (PRESIDENT)
(213) 725-8915
Entity
Organization
Contact information
Practice address
1107 CRENSHAW BLVD, LOS ANGELES, CA 90019-3112
(818) 732-0369
Mailing address
1107 CRENSHAW BLVD, LOS ANGELES, CA 90019-3112
(818) 732-0369
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164076774
CALIFORNIA ACUPUNCTURE BOARD
CA
01
—
1700465937
CALIFORNIA ACUPUNCTURE BOARD
CA
Enumeration date
01/15/2024
Last updated
01/07/2025
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