Organization
IMIDEOLOGY INC
Active
Organization
IMIDEOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIN LEE (CEO)
(203) 233-0116
Entity
Organization
Contact information
Practice address
3940 LOUIS RD, PALO ALTO, CA 94303-4544
(203) 233-0116
Mailing address
3940 LOUIS RD, PALO ALTO, CA 94303-4544
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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