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Organization
HEE SOO JEONG MD A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
HEE SOO JEONG MD A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Mirae Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
HEE SOO JEONG M.D. (PRESIDENT)
(213) 387-1541
Entity
Organization
Contact information
Practice address
2675 W OLYMPIC BLVD, SUITE 202, LOS ANGELES, CA 90006-2880
(213) 387-1541
(866) 531-4907
Mailing address
2675 W OLYMPIC BLVD, SUITE 202, LOS ANGELES, CA 90006-2880
(213) 387-1541
(866) 531-4907
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A105825
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A105825
PROFESSIONAL LICENSE
CA
Enumeration date
05/12/2014
Last updated
05/12/2014
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