Organization
LYSANDER JIM, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYSANDER JIM M.D. (PRESIDENT)
(626) 800-3860
Entity
Organization
Contact information
Practice address
452 N ALTADENA DR, PASADENA, CA 91107-2536
(626) 800-3860
Mailing address
601 CAMINO VERDE, S PASADENA, CA 91030-4139
(626) 800-3860
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3985886
CA
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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