| NPI | 1023263555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS T. LEE Owner 909-902-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G48262) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A37294) |
| 207Q00000X Family Medicine (Licence: CA G48262) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA G48262) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA A37294) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: CA G48262) | |
| 208200000X Plastic Surgery (Licence: CA G48262) | |
| 2086X0206X Surgery Surgical Oncology (Licence: AZ G48262) | |
| 208D00000X General Practice (Licence: CA G48262) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CA G48262) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2008-11-25 |