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Organization
LILLY KAO, M.D., INC.
Active
Organization
LILLY KAO, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI R GRANESE (COO)
(949) 489-5564
Entity
Organization
Contact information
Practice address
14351 RED HILL AVE, SUITE C, TUSTIN, CA 92780-6271
(714) 838-5562
(714) 838-5560
Mailing address
28 MONARCH BAY PLZ, SUITE N, DANA POINT, CA 92629-3460
(949) 489-5564
(949) 493-9350
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C53602
CA
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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