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Organization
LEE RICE D.O. MEDICAL CORPORATION
Active
Organization
LEE RICE D.O. MEDICAL CORPORATION
Active
Other names
Lifewellness Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M LARSON MD (PHYSICIAN)
(619) 398-2960
Entity
Organization
Contact information
Practice address
2448 HISTORIC DECATUR RD STE 130, SAN DIEGO, CA 92106-6127
(619) 398-2960
(619) 398-2970
Mailing address
2448 HISTORIC DECATUR RD STE 130, SAN DIEGO, CA 92106-6127
(619) 398-2960
(619) 398-2970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A3360
CA
207Q00000X
Family Medicine Physician
A122666
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
20A3360
CA
2084P0800X
Psychiatry Physician
A122666
CA
Other
Enumeration date
04/02/2018
Last updated
06/16/2018
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