Organization
NEW LIGHT MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEONG-OK LEE M.D. (PRESIDENT)
(714) 635-0600
Entity
Organization
Contact information
Practice address
1801 W ROMNEYA DR, STE #606, ANAHEIM, CA 92801-1828
(714) 635-0600
(714) 635-0610
Mailing address
1801 W ROMNEYA DR, STE #606, ANAHEIM, CA 92801-1828
(714) 635-0600
(714) 635-0610
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
—
—
302R00000X
Health Maintenance Organization
Primary
A39186
CA
305R00000X
Preferred Provider Organization
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
05/29/2009
Last updated
03/18/2014
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