Individual
MR. DWAYNE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1219 CAMINO DEL MAR, DEL MAR, CA 92014-2505
(858) 793-1104
Mailing address
6151 VERDA LN, SAN DIEGO, CA 92130-6931
(760) 390-6848
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
10136
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10136
CA STATE BOARD LICENSE NUMBER
CA
Enumeration date
05/25/2007
Last updated
02/12/2013
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