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Organization

TIME MEDICAL BIOTECH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAE LEE MD (PRESIDENT)
(323) 852-3245
Entity
Organization

Contact information

Practice address
815 S ARDMORE AVE, LOS ANGELES, CA 90005-2597
(323) 852-3245
Mailing address
815 S ARDMORE AVE, LOS ANGELES, CA 90005-2597
(323) 852-3245

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A32086
CALIFORNIA MEDICAL BOARD
CA
Enumeration date
02/27/2019
Last updated
02/27/2019
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