| NPI | 1962436147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK-KWAN KETCHUM LEE President/Physician 661-327-3271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A29649) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |