Organization
KOREA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG TAI LEE M.D. (DIRECTOR)
(323) 731-0681
Entity
Organization
Contact information
Practice address
3544 W OLYMPIC BLVD STE 105, LOS ANGELES, CA 90019-3529
(323) 731-0681
(323) 731-0832
Mailing address
3544 W OLYMPIC BLVD STE 105, LOS ANGELES, CA 90019-3529
(323) 731-0681
(323) 731-0832
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G67974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090150
—
CA
Enumeration date
08/31/2006
Last updated
12/12/2010
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