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Individual

JACK DONOVAN LEMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
622 W DUARTE RD STE 101, ARCADIA, CA 91007-9266
(626) 254-9010
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A187679
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
A187679
CA

Other

Enumeration date
04/01/2019
Last updated
05/14/2024
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