Provider Demographics
NPI:1053531020
Name:LEE, DONGKUN (LAC)
Entity type:Individual
Prefix:MR
First Name:DONGKUN
Middle Name:
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 1:1920 E KATELLA AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5146
Mailing Address - Country:US
Mailing Address - Phone:714-633-0080
Mailing Address - Fax:714-633-0080
Practice Address - Street 1:1920 E KATELLA AVE STE F
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5149
Practice Address - Country:US
Practice Address - Phone:714-633-0080
Practice Address - Fax:714-790-4080
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11683171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist