Provider Demographics
NPI:1447314257
Name:LEE, JOHN Y (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:Y
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 BARRANCA PKWY
Mailing Address - Street 2:STE 310
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8289
Mailing Address - Country:US
Mailing Address - Phone:949-552-5094
Mailing Address - Fax:949-552-5096
Practice Address - Street 1:4482 BARRANCA PKWY
Practice Address - Street 2:SUITE 192
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-7701
Practice Address - Country:US
Practice Address - Phone:949-552-5094
Practice Address - Fax:949-552-5096
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor