Organization
BENEFIT SURGERY MEDICAL CENTER
Active
Other names
Benefit Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
YONG TAI LEE MD (CEO)
(909) 989-4100
Entity
Organization
Contact information
Practice address
9674 ARCHIBALD AVE, SUITE 125, RANCHO CUCAMONGA, CA 91730
(909) 989-4100
(909) 989-5400
Mailing address
9674 ARCHIBALD AVE, SUITE 125, RANCHO CUCAMONGA, CA 91730
(909) 989-4100
(909) 989-5400
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
240000845
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240000845
SURG. CLINIC LICENSE DHS
CA
Enumeration date
05/20/2006
Last updated
06/03/2008
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