Organization
MINIMALLY INVASIVE THERAPIES A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL SHIN KWON LEE M.D. (CEO)
(660) 349-0020
Entity
Organization
Contact information
Practice address
18400 US HIGHWAY 18, SUITE A, APPLE VALLEY, CA 92307-2306
(760) 242-3939
(760) 810-7593
Mailing address
11202 LINDSAY LN, APPLE VALLEY, CA 92308-3637
(660) 349-0020
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A49819
CA
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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