MEDICARE: LEMUS MEDICAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center	G42274	CA

General Provider Information

NPI Number	:	1033429691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEMUS MEDICAL, INC.

Provider Business Mailing Address
First Line	:	5020 E. WASHINGTON BLVD.
Second Line	:
City	:	COMMERCE
State	:	CA
Zip	:	90040-1237
Country	:	US
Telephone Number	:	323-260-7900
Fax Number	:	323-260-1087

Provider Business Practice Location Address
First Line	:	5020 E. WASHINGTON BLVD.
Second Line	:
City	:	COMMERCE
State	:	CA
Zip	:	90040-1237
Country	:	US
Telephone Number	:	323-260-7900
Fax Number	:	323-260-1087

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	DR. JAMES LEMUS
Credential	:	M.D.
Telephone Number	:	323-260-7900

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	10/18/2010

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