# JAIME S. LEE HO MD INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mt Mesa Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629081997
- **Authorized official:** JAIME S. LEE HO M.D. (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (760) 379-2426

## Contact information

- **Practice address:** 4308 BIRCH STREET, LAKE ISABELLA, CA 93240
- **Practice address phone:** (760) 379-2426
- **Practice address fax:** (760) 379-2664
- **Mailing address:** PO BOX 1898, 4308 BIRCH STREET, LAKE ISABELLA, CA 93240-1898
- **Mailing address phone:** (760) 379-2426
- **Mailing address fax:** (760) 379-2664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | G43717 | CA | — |
| 208D00000X | General Practice Physician | A24547 | CA | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 09/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0022310 | — | CA |