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Organization

FUNCTIONAL MEDICINE AND PSYCHIATRY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN LEE MD (PRESIDENT)
(626) 449-7000
Entity
Organization

Contact information

Practice address
4358 CHEVY CHASE DR, LA CANADA FLINTRIDGE, CA 91011-3203
(626) 449-7000
Mailing address
115 W CALIFORNIA BLVD UNIT 9001, PASADENA, CA 91105-3005
(626) 449-7000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1689618464
NPI
CA
Enumeration date
04/15/2022
Last updated
04/15/2022
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